What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?
Purpose It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study. Methods A total of 300 k...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2016-08, Vol.24 (8), p.2704-2709 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Harato, Kengo Maeno, Shinichi Tanikawa, Hidenori Kaneda, Kazuya Morishige, Yutaro Nomoto, So Niki, Yasuo |
| description | Purpose
It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study.
Methods
A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively.
Results
Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts,
P
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| doi_str_mv | 10.1007/s00167-015-3554-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1811886491</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1808603792</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-129f02c43545ba57616968d44e786d834eb6e0bbe74d01b1e43164170c5cc3683</originalsourceid><addsrcrecordid>eNqNkV1rFDEUhoNY7Lb6A7yRgDfejJ4z-Zq5EilqhYI3Lb0Mmdmzu6mTzJpkhPrrTd1VRBC8Skie9wk5L2PPEV4jgHmTAVCbBlA1QinZiEdshVKIxghpHrMV9LJtWlD6lJ3lfAdQt7J_wk5bZaQAKVYs3O5c4S4RLzviPuznVFwsPLg40_ItUeabOfGBtj5GSpmXmQcfffDfieclbf3oJl58qOHI98kHl-4rVOrpl0hU1WWX5v3kcrl_-5SdbNyU6dlxPWc3H95fX1w2V58_frp4d9WMElRpsO030I5SKKkGp4xG3etuLSWZTq87IWnQBMNARq4BByQpUEs0MKpxFLoT5-zVwbtP89eFcrHB55GmyUWal2yxQ-y6Ogv8DxQ6DcL0bUVf_oXezUuK9SM_hRVCUJXCAzWmOedEG3ucikWwD7XZQ2221mYfarOiZl4czcsQaP078aunCrQHINeruKX0x9P_tP4Aj8Wh0A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1811037105</pqid></control><display><type>article</type><title>What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Harato, Kengo ; Maeno, Shinichi ; Tanikawa, Hidenori ; Kaneda, Kazuya ; Morishige, Yutaro ; Nomoto, So ; Niki, Yasuo</creator><creatorcontrib>Harato, Kengo ; Maeno, Shinichi ; Tanikawa, Hidenori ; Kaneda, Kazuya ; Morishige, Yutaro ; Nomoto, So ; Niki, Yasuo</creatorcontrib><description>Purpose
It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study.
Methods
A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively.
Results
Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts,
P
< 0.05).
Conclusion
Beginners took more time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners.
Level of evidence
Therapeutic studies, Level IV.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-015-3554-3</identifier><identifier>PMID: 25743043</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Arthritis ; Arthroplasty, Replacement, Knee - education ; Arthroplasty, Replacement, Knee - methods ; Bone surgery ; Clinical Competence ; Cognition & reasoning ; Decision making ; Education ; Female ; Humans ; Joint replacement surgery ; Knee ; Male ; Medicine ; Medicine & Public Health ; Operative Time ; Orthopedics ; Prospective Studies ; Skills ; Surgeons ; Surgical techniques</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016-08, Vol.24 (8), p.2704-2709</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-129f02c43545ba57616968d44e786d834eb6e0bbe74d01b1e43164170c5cc3683</citedby><cites>FETCH-LOGICAL-c405t-129f02c43545ba57616968d44e786d834eb6e0bbe74d01b1e43164170c5cc3683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-015-3554-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-015-3554-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25743043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harato, Kengo</creatorcontrib><creatorcontrib>Maeno, Shinichi</creatorcontrib><creatorcontrib>Tanikawa, Hidenori</creatorcontrib><creatorcontrib>Kaneda, Kazuya</creatorcontrib><creatorcontrib>Morishige, Yutaro</creatorcontrib><creatorcontrib>Nomoto, So</creatorcontrib><creatorcontrib>Niki, Yasuo</creatorcontrib><title>What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study.
Methods
A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively.
Results
Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts,
P
< 0.05).
Conclusion
Beginners took more time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners.
Level of evidence
Therapeutic studies, Level IV.</description><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Knee - education</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Bone surgery</subject><subject>Clinical Competence</subject><subject>Cognition & reasoning</subject><subject>Decision making</subject><subject>Education</subject><subject>Female</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Operative Time</subject><subject>Orthopedics</subject><subject>Prospective Studies</subject><subject>Skills</subject><subject>Surgeons</subject><subject>Surgical techniques</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkV1rFDEUhoNY7Lb6A7yRgDfejJ4z-Zq5EilqhYI3Lb0Mmdmzu6mTzJpkhPrrTd1VRBC8Skie9wk5L2PPEV4jgHmTAVCbBlA1QinZiEdshVKIxghpHrMV9LJtWlD6lJ3lfAdQt7J_wk5bZaQAKVYs3O5c4S4RLzviPuznVFwsPLg40_ItUeabOfGBtj5GSpmXmQcfffDfieclbf3oJl58qOHI98kHl-4rVOrpl0hU1WWX5v3kcrl_-5SdbNyU6dlxPWc3H95fX1w2V58_frp4d9WMElRpsO030I5SKKkGp4xG3etuLSWZTq87IWnQBMNARq4BByQpUEs0MKpxFLoT5-zVwbtP89eFcrHB55GmyUWal2yxQ-y6Ogv8DxQ6DcL0bUVf_oXezUuK9SM_hRVCUJXCAzWmOedEG3ucikWwD7XZQ2221mYfarOiZl4czcsQaP078aunCrQHINeruKX0x9P_tP4Aj8Wh0A</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Harato, Kengo</creator><creator>Maeno, Shinichi</creator><creator>Tanikawa, Hidenori</creator><creator>Kaneda, Kazuya</creator><creator>Morishige, Yutaro</creator><creator>Nomoto, So</creator><creator>Niki, Yasuo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?</title><author>Harato, Kengo ; Maeno, Shinichi ; Tanikawa, Hidenori ; Kaneda, Kazuya ; Morishige, Yutaro ; Nomoto, So ; Niki, Yasuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-129f02c43545ba57616968d44e786d834eb6e0bbe74d01b1e43164170c5cc3683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Arthritis</topic><topic>Arthroplasty, Replacement, Knee - education</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Bone surgery</topic><topic>Clinical Competence</topic><topic>Cognition & reasoning</topic><topic>Decision making</topic><topic>Education</topic><topic>Female</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Operative Time</topic><topic>Orthopedics</topic><topic>Prospective Studies</topic><topic>Skills</topic><topic>Surgeons</topic><topic>Surgical techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harato, Kengo</creatorcontrib><creatorcontrib>Maeno, Shinichi</creatorcontrib><creatorcontrib>Tanikawa, Hidenori</creatorcontrib><creatorcontrib>Kaneda, Kazuya</creatorcontrib><creatorcontrib>Morishige, Yutaro</creatorcontrib><creatorcontrib>Nomoto, So</creatorcontrib><creatorcontrib>Niki, Yasuo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harato, Kengo</au><au>Maeno, Shinichi</au><au>Tanikawa, Hidenori</au><au>Kaneda, Kazuya</au><au>Morishige, Yutaro</au><au>Nomoto, So</au><au>Niki, Yasuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>24</volume><issue>8</issue><spage>2704</spage><epage>2709</epage><pages>2704-2709</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study.
Methods
A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively.
Results
Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts,
P
< 0.05).
Conclusion
Beginners took more time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners.
Level of evidence
Therapeutic studies, Level IV.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25743043</pmid><doi>10.1007/s00167-015-3554-3</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016-08, Vol.24 (8), p.2704-2709 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Aged Arthritis Arthroplasty, Replacement, Knee - education Arthroplasty, Replacement, Knee - methods Bone surgery Clinical Competence Cognition & reasoning Decision making Education Female Humans Joint replacement surgery Knee Male Medicine Medicine & Public Health Operative Time Orthopedics Prospective Studies Skills Surgeons Surgical techniques |
| title | What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty? |
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