Perioperative and postoperative outcomes in single-surgeon versus dual-surgeon acetabular fracture cases

To investigate the impacts of utilizing dual-scrubbing surgeons on both perioperative and postoperative outcomes in acetabular open reduction and internal fixation (ORIF) procedures.

Design retrospective comparative cohort study. Setting single academic medical center in Kansas City, KS. Patient selection criteria patients aged 18-90 who underwent acetabular ORIF between January 1, 2007-September 1, 2022, by two fellowship-trained orthopedic traumatologists either individually or simultaneously. Outcome Measures and Comparisons operating time, estimated blood loss (EBL), Matta's quality of reduction, follow-up time, number of follow-up appointments, and intra-operative and postoperative complications were extracted and analyzed.

169 cases were included in the analysis. 125 (74%) were single-surgeon cases, while 44 (26%) were dual-surgeon cases. Body mass index (BMI) was significantly higher in the dual-surgeon group, while single-surgeon group had more incidences of prior hip or surgery. Postoperative complications including infection, avascular necrosis, sciatic nerve palsy, and nonunion did not vary between the two groups. The dual-surgeon group demonstrated significantly greater operating times and EBL with a notably inferior quality of reduction assessed by Matta's criteria. Lack of postoperative complication was an independent predictor for achieving a quality reduction. Dual-surgeon cases, older age, male sex, and prior surgery were associated with poorer reduction outcomes..

Dual-surgeon acetabular ORIF cases were associated with longer operating times, increased EBL, and inferior quality of reduction in comparison to cases performed by the single surgeon cohort. Despite these observations, further investigation with randomized controlled trials is warranted to establish definitive conclusions regarding the benefits or disadvantages of dual-surgeon utilization for acetabular ORIF.