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Surgery performed by supervised registrars does not adversely affect medium-term functional outcomes after total knee
N Beattie1, J F Maempel1, S Roberts1
1NHS Fife , UK.
Annals of the Royal College of Surgeons of England
|October 13, 2017
Summary
Total knee arthroplasty (TKA) performed by supervised trainees yields functional outcomes equivalent to those by consultants. This study found no significant differences in patient recovery or long-term results, supporting trainee involvement in TKA.
Area of Science:
- Orthopaedic Surgery
- Surgical Training
- Patient Outcomes
Background:
- Total knee arthroplasty (TKA) is a common procedure for orthopaedic trainees.
- Limited research exists on functional outcomes of TKA performed by supervised trainees compared to consultants.
Purpose of the Study:
- To compare functional outcomes up to five years post-primary TKA between consultant and trainee surgeons.
- To assess the impact of trainee involvement on operative time, length of stay, and complication rates.
Main Methods:
- Retrospective analysis of prospectively collected data from 609 TKA patients.
- Assessment using American Knee Society objective knee and functional scores (AKSK and AKSF) preoperatively and at 18 months, 3, and 5 years postoperatively.
Main Results:
- No significant differences in preoperative characteristics, operative time, transfusion rates, length of stay, manipulation under anesthesia, or mortality between consultant and trainee groups.
- Similar improvements in AKSK and AKSF scores, and comparable range of motion at five years post-TKA.
Conclusions:
- Supervised trainee-performed TKA achieves functional outcomes equivalent to consultant-performed TKA.
- Trainee involvement does not negatively impact operative efficiency, length of stay, transfusion rates, or patient range of motion.