编辑评论:关节透视体积到能力的学习曲线辩论很复杂:学习"足够是足够的"是终身的纪律
概括
关节镜学习曲线的差异很大,结果随着外科医生的经验而改善. 大量的中心显示出更好的结果,但患者选择和混因素使直接比较复杂化.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
背景情况:
- 关节镜越来越多地被利用,为住院生和研究员提供了实践培训.
- 最佳的患者结果和长期的成功与拉布拉修复/重建和囊关闭相比,与脱bridement有关.
研究的目的:
- 检查关节透镜体积和外科医生的能力之间的关系.
- 分析影响关节镜学习曲线和结果的因素.
主要方法:
- 对关节镜学习曲线的现有文献的综述.
- 对大型数据库研究的分析,比较基于手术体积的结果.
- 在大批量中心研究中考虑潜在的偏见.
主要成果:
- 减少引时间,并发症和重复手术与病例数量增加相关.
- 关节镜学习曲线的平原范围很大,从30到520个案例.
- 高人数中心的再入院和并发症率较低,尽管存在偏见.
结论:
- 关节镜术的学习曲线是复杂的,受外科医生的经验和患者因素的影响.
- 由于病例数量和潜在的选择性患者管理,大批量中心可能会提供更好的结果.
- 确定外科能力是一个持续的过程,而不是一定的病例数.
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