The impact of surgical trainee involvement in total knee arthroplasty: a systematic review of surgical efficacy, patient safety, and outcomes
- 13.01.2022
- Original Article
Erschienen in:
- Verfasst von
- Ryan S. Marder
- Neil V. Shah
- Qais Naziri
- Aditya V. Maheshwari
- Erschienen in
- European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 2/2023
Abstract
Purpose
Trainee involvement in patient care has raised concerns about the potential risk of adverse outcomes and harming patients. We sought to analyze the impact and potential consequence of surgical trainee involvement in total knee arthroplasty (TKA) procedures in terms of surgical efficacy, patient safety, and functional outcomes.
Methods
We systematically reviewed Medline/PubMed, EMBASE, the Cochrane library, and Scopus databases in April 2021. Eligible studies reported on the impact of trainee participation in TKA procedures performed with and without such involvement.
Results
Twenty-three publications met our eligibility criteria and were included in our study. These studies reported on 132,624 surgeries completed on 132,416 patients. Specifically, 23,988 and 108,636 TKAs were performed with and without trainee involvement, respectively. The mean operative times for procedures with (n = 19,573) and without (n = 94,581) trainee involvement were 99.77 and 85.05 min, respectively. Both studies that reported data on cost of TKAs indicated a significant increase (p < 0.001) associated with procedures completed by teaching hospitals compared to private practices. Mean overall complication rates were 7.20% and 7.36% for TKAs performed with (n = 9,386) and without (n = 31,406) trainees. Lastly, the mean Knee Society Scale (KSS) knee scores for TKAs with (n = 478) and without (n = 806) trainee involvement were similar; 82.81 and 82.71, respectively.
Conclusion
Our systematic review concurred with previous studies that reported trainee involvement during TKAs increases the mean operative time. However, the overall complication rates and functional outcomes were similar. Larger studies with a better methodology and higher level of evidence are still needed for a resolute conclusion.
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- Titel
- The impact of surgical trainee involvement in total knee arthroplasty: a systematic review of surgical efficacy, patient safety, and outcomes
- Verfasst von
-
Ryan S. Marder
Neil V. Shah
Qais Naziri
Aditya V. Maheshwari
- Publikationsdatum
- 13.01.2022
- Verlag
- Springer Paris
- Erschienen in
-
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 2/2023
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068 - DOI
- https://doi.org/10.1007/s00590-021-03179-7
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