Journal article
The risk of revision surgery after trainee-led primary total hip replacement
- Abstract:
-
Introduction
The aim of this study was to determine the impact of operating surgeon grade and level of supervision on the incidence of one-year patient mortality and all-cause revision following elective primary total hip replacement (THR).
Methods
National Joint Registry data from 2005 to 2020 for a single University Teaching Hospital were used, with analysis performed on the 15-year dataset divided into 5-year block periods (B1, 2005-2010; B2, 2010-2015; B3, 2015-2020). Outcome measures were mortality and revision surgery at one year, in relation to lead surgeon grade, and level of supervision for trainee-led (TL) operations.
Results
A total of 9,999 eligible primary THRs were performed, of which 5,526 (55.3%) were consultant-led (CL), and 4,473 (44.7%) TL. Of TL, 2,404 (53.7%) were nonconsultant-supervised (TU) and 2,069 (46.3%) consultant-supervised (TS). The incidence of one-year patient mortality was 2.05% (n=205), and all-cause revision was 1.11% (n=111). There was no difference in one-year mortality between TL and CL operations (p=0.20, odds ratio (OR) 0.78, confidence interval (CI) 0.55-1.10). The incidence of one-year revision was not different for TL and CL operations (p=0.15, OR 1.37, CI 0.89-2.09). Overall, there was no temporal change for either outcome measure between TL or CL operations. A significant increase in revision within one-year was observed in B3 between TU compared with CL operations (p=0.005, OR 2.81, CI 1.35-5.87).
Conclusions
We found no difference in overall one-year mortality or all-cause revision rate between TL and CL primary THR. Despite a reduction in unsupervised THR in the latest five-year period (2015-2020), unsupervised TL THR resulted in an increased risk of early revision.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 423.0KB, Terms of use)
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- Publisher copy:
- 10.1308/rcsann.2024.0049
Authors
+ National Institute for Health Research
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- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- NIHR202367/554066
- Publisher:
- Royal College of Surgeons of England
- Journal:
- Annals of The Royal College of Surgeons of England More from this journal
- Volume:
- 107
- Issue:
- 4
- Pages:
- 275-284
- Place of publication:
- England
- Publication date:
- 2024-11-21
- Acceptance date:
- 2024-05-02
- DOI:
- EISSN:
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1478-7083
- ISSN:
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0035-8843
- Pmid:
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39570304
- Language:
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English
- Keywords:
- Pubs id:
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2064469
- Local pid:
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pubs:2064469
- Deposit date:
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2025-05-16
- ARK identifier:
Terms of use
- Copyright holder:
- Howgate et al.
- Copyright date:
- 2025
- Rights statement:
- © 2025, The Authors. Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, reproduction, and adaptation in any medium, provided the original work is properly attributed.
- Licence:
- CC Attribution (CC BY)
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