CORRInsights®: Does Surgeon Experience Impact the Risk of Complications After Bernese Periacetabular Osteotomy?

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Osteotomy to improve a dysplastic hip with undamaged cartilage can prolong the lifespan of the patient's native hip. However, osteotomy of the hip, particularly the Bernese periacetabular osteotomy (PAO) [1], is technically demanding. Recently, I had the opportunity to attend a lecture by Prof. Kjeld Søballe, who presented a minimally invasive Bernese PAO approach [3] and its results. At 5 years followup [4], the hip joint survival rates were 97% in 165 patients in the minimally invasive group and 93% in 98 patients in the ilioinguinal group. There were no moderate or major short-term complications in the minimally invasive group and 3% in the ilioinguinal group [4].
The Bernese PAO requires an experienced surgeon because the nerves and vessels are in close proximity, and the osteotomy itself must be created and positioned with great precision. More than many procedures, this one calls for skill, dedication, and poise on the part of the surgeon.
Although the results of the current study cannot be generalized in a straightforward manner, it reports that two young surgeons performed the Bernese PAO with a similar frequency of major complications compared to more experienced surgeons (6% with no residual disability 1 year after the operation). The young surgeons required less time for the operation as they increased their number of operations performed, suggesting that experience indeed improved their efficiency.
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