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Junior surgeon learning curve for performing digital planning of a first-line uncemented total hip prothesis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Preoperative digital planning of total hip arthroplasty (THA) anticipates difficulties while increasing implant survival. The objective was to establish the learning curve to produce a reliable and reproducible preoperative planning for THA. We hypothesize that a learning curve exists for planning, and we want to determine the number of procedures required to accomplish it.

Methods

This prospective study included patients for THA from 02/11/2019 to 01/11/2022. Ten junior (Juniors) and senior surgeons (Seniors) had received dedicated training in the use of the software. Modeling was done blindly by Juniors and Senior before surgery on a standardized front pelvis X-ray (mediCAD 2D Classic Hospital software). Statistical analyses to establish the learning curve were done to compare the Juniors and Seniors.

Results

60% of the Juniors achieved competence after 31.5 ± 12.9 [14–54] planning sessions for the acetabular implant, and 80% after 30.3 ± 8.3 [17–40] planning sessions for the femoral implant. Femoral neck size was achieved by all ten Juniors after 23.1 ± 6.8 [17–38] planning. The offset was correctly restored on the plan by 30% of the Juniors after 33.5 ± 11.6 [18–46] planning.

Conclusion

There is a learning curve for 2D planning of uncemented THA. The different planning items seem to have different learning curves. Compared to Seniors, the completion of 75 planning sessions is not sufficient in totality. The competence of the Juniors for the acetabular implant, the length of the neck and the size of the femoral stem are mostly acquired before 75 sessions.

Level of evidence

Prospective study—Level II.

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Authors and Affiliations

  1. Département de Chirurgie Osseuse, CHU-Angers, 4, rue Larrey, 49933, Angers Cedex 9, France

    S. Cypel, G. Heliere, G. David & L. Rony

  2. Service d’orthopédie, Hopital Lariboisière, 2 rue Ambroise Paré, 75015, Paris, France

    P.-A. Bouche

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  1. S. Cypel
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  2. P.-A. Bouche
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  3. G. Heliere
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  4. G. David
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  5. L. Rony
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Correspondence to L. Rony.

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Cypel, S., Bouche, PA., Heliere, G. et al. Junior surgeon learning curve for performing digital planning of a first-line uncemented total hip prothesis. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03986-8

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