Abstract
Objective: We set out to identify if the quality of femoral cementing as assessed on the first postoperative AP radiograph was significantly different when operations performed by trainees were compared with those done by consultant staff.
The Barrack scoring system was used as a tool to evaluating cementation quality in all cases.
Material and Method: 70 patients with primary hip replacement were included. 41 cases performed by consultant while 29 by training surgeons.1st post-operative hip x-rays were taken between 3–5 days postoperatively. The x-rays were numbered randomly and their digital images were graded using Barrack grades by one observer (I.R) who was blinded to the seniority of surgeon who had carried out the case.
Results: Of the total cohort of 70 patients, 35(50%) were grade A, 28(40%) grade B and 7(10%) grade C. In the consultant cases 18(44%) were grade A, 19(46%) grade B and 4(10%) were grade C. The results in for training grade surgeons were 17(58%) grade A, 9 (31%) grade B and 3(11%) grade C. There were no grade D cases in either group.
Conclusion: The quality of femoral cementing was not significantly different when the operations carried out by consultants were compared to those where a trainee was the primary surgeon (p< 0.01). These results would suggest that learning curve (Figure) from trainees to consultants was quite satisfactory. Patients undergoing operation undertaken by an adequately experienced and supervised trainee are not at increased risk for implant failure compared to the individuals where the Consultant is the primary surgeon.
Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.
