Learning curves in orthopaedic surgery: a case for super-specialisation?

ABSTRACT

INTRODUCTION: The objective of this study was to assess if there is a significant learning curve in the treatment of developmental dysplasia of the hip. PATIENTS AND METHODS: We followed up cases of developmental dysplasia of the hip treated by a single surgeon over a 12-year period. There were 96 cases, 56 treated by open reduction and 40 treated by closed reduction. Assessment was made of the incidence and degree of avascular necrosis in the treated hips, as a radiological outcome measure. RESULTS: Plotting the cumulative percentage of satisfactory outcomes demonstrated an increasingly high percentage of satisfactory results with increasing number of procedures performed, i.e. as the surgeon progressed up the 'learning curve'. CONCLUSIONS: This study demonstrates a learning curve in the treatment of developmental dysplasia of the hip. It may be possible to draw parallels to other treatments, and also support for the growing trend to specialisation.