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Experience Makes for Effective Surgery; A Study in Orthopedics

Posted on Mar 17, 2012

We all understand that, like any skill, surgeries take some getting used to, and it's to be expected that surgeons make more mistakes when just starting out than when they're veterans. A recent study calculated the difference for us in orthopedics.

The study looked at reconstructive surgeries of the anterior cruciate ligament (ACL), which is a ligament that connects the knee. The first 10 ACL surgeries of a surgeon's career were found to incur a 5-fold increased risk of a second ACL operation within a year, compared with those ACL surgeries performed by surgeons with over 150 such operations under his/her belt. For some perspective, the rate of repeat surgeries within a year for the least experienced surgeon is 1.7%.

The study has a few limitations. It did not answer whether further reconstructive surgeries were necessary after the first year. It also did not specify whether the second surgery was on the same knee, though it often is.

One of the authors of the study says ACL reconstructive surgery is common but relatively complex.

He advised for experienced surgeons to supervise less experienced colleagues more often. He warned that subspecialty fellowship training does not significantly improve performance and closed: "There's no substitute for doing independent surgery."


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