Current Total Hip Arthroplasty Resident Experience During Orthopaedic Surgery Training: A Self-Reported Survey
John Mazzocco1, Alexis Driscoll1, Kathleen He2
1Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts.
Background:
Total hip arthroplasty (THA) has trended toward increased utilization of the direct anterior approach (DAA) and robotic assistance in recent years. This study aimed to characterize self-reported trainee exposure to THA techniques during residency.
Methods:
This study anonymously surveyed orthopaedic surgery residents using 21 multiple-choice questions. Orthopaedic surgery residency program coordinators were asked to forward the survey to their residents. Demographic and residency program information, exposure to THA techniques, and confidence performing these procedures were collected. Descriptive statistics, Kruskal-Wallis tests, and ordinal logistic regression were performed.
Results:
There were 94 residents who responded to the survey, with most respondents from the Northeast (39.4%) and university hospital-based programs (50.0%). There were 57 (60.6%) who responded that over half of THAs utilized the DAA, while 26 (27.7%) responded that the posterior approach (PA) was primarily utilized. There were 80 (85.1%) who had no exposure to the supercapsular approach, and 34 (36.2%) and 48 (51.1%) had no exposure to anterolateral and direct lateral approaches, respectively. All respondents had exposure to multiple surgical approaches. There were 50 (53.2%) who reported zero exposure to robotic-assisted THA. Program region was associated with the greatest exposure to DAA (P < 0.001), anterolateral (P = 0.021), posterior (P = 0.018), and supercapsular (P < 0.001) approaches. Compared to the PA, residents who were most exposed to DAA reported higher levels of comfort (P = 0.027). Resident comfort increased with advancing postgraduate year (P < 0.001). There were 50 (53.2%) who responded they were planning to perform THAs in practice, with 61 (64.9%) stating they would use the DAA and 30 (31.9%) responding they would use the PA.
Conclusions:
The increase in popularity of the DAA in THA has also been realized in orthopaedic resident training. Most respondents reported satisfaction with their experience and reported exposure to multiple techniques.
