ArticlePloS one2018
Surgical training does not affect operative time and outcome in total knee arthroplasty.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association of resident training with complication risk in total hip and knee arthroplasty: a systematic review and meta-analysis.Acta orthopaedica · 2025Pooled it
- The impact of surgical trainee involvement in total knee arthroplasty: a systematic review of surgical efficacy, patient safety, and outcomes.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Surgical complications in total knee arthroplasty performed by trainee surgeons under scrubbed attending supervision.International orthopaedics · 2026Article
- Step-specific learning curve of the TMINI robotic system for total knee arthroplasty: a single-surgeon CUSUM analysis.Journal of robotic surgery · 2026Article
- Effect of Orthopedic Resident Surgical Education on Surgical Case Length and Healthcare Costs.Journal of hand surgery global online · 2026Article
- Intrainstitutional Changes of the Treatment of Supracondylar Humerus Fracture in Children over a Period of 9 Years.Children (Basel, Switzerland) · 2023Article
- Enhanced Recovery after Surgery Applied to Pediatric Laparoscopic Cholecystectomy for Simple Cholelithiasis: Feasibility and Teaching Insights.Children (Basel, Switzerland) · 2023Article
- Initial Learning Curve for Robot-Assisted Total Knee Arthroplasty in a Dedicated Orthopedics Center.Journal of clinical medicine · 2023Article
- Single Surgeon versus Co-Surgeons in Primary Total Joint Arthroplasty: Does "Two Is Better than One" Apply to Surgeons?Journal of personalized medicine · 2022Article
- Does Resident Participation Influence Surgical Time and Clinical Outcomes? An Analysis on Primary Bilateral Single-Staged Sequential Total Knee Arthroplasty.Arthroplasty today · 2022Article
- Imageless robotic-assisted revision arthroplasty from UKA to TKA : Surgical technique and case-control study compared with primary robotic TKA.Der Orthopade · 2021Article
- Patients' perspectives on the extent of resident participation in the operating room for total hip oxr knee arthroplasty.Canadian medical education journal · 2021Article
- Surgical Duration Implicated in Major Postoperative Complications in Total Hip and Total Knee Arthroplasty: A Retrospective Cohort Study.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2020Article
- Early clinical outcome and learning curve following unilateral primary total knee arthroplasty after introduction of a novel total knee arthroplasty system.World journal of orthopedics · 2020Article
- Outcomes and component-positioning in total knee arthroplasty may be comparable between supervised trained surgeons and their supervisor.Knee surgery & related research · 2020Article
- Absence of cytotoxic and inflammatory effects following in vitro exposure of chondrogenically-differentiated human mesenchymal stem cells to adenosine, lidocaine and MgJournal of experimental orthopaedics · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Training the next generation of orthopaedic surgeons in total knee arthroplasty (TKA) is crucial, but might affect operative time and outcome. We hypothesized that the learning curve of residents in TKA has an impact on (1) operative time, (2) complication rates and (3) early postoperative outcome. In a retrospective analysis of 738 primary TKAs from our institutional joint registry, operative time, complication rates, patient-reported outcome measures (EQ-5D, WOMAC) within the first year and responder rates for positive outcome as defined by the OMERACT-OARSI criteria were compared between trainee and senior surgeons differentiating between conventional and navigated TKA. Mean operative time was 69.5±18.5min for trainees compared to 77.3±25.8min for senior surgeons (95%CI of the difference 1.5-13.9min, p = 0.02) in conventional TKA and 80.4±22.1min to 84.1±27.6min (95%CI of the difference -0.9-8.2min, p = 0.12) for navigated TKA, respectively. Intraoperative fracture (p≥0.36), thrombosis (p≥0.90), neurological deficits (p≥0.90) and infection rates (p≥0.28) were comparably low in both groups. Patient-reported outcome measures one year after TKA were similar for trainee and senior surgeons with EQ-5D 0.83±0.17 to 0.80±0.21 (p = 0.25) and WOMAC 74.85±18.60 to 72.77±20.12 (p = 0.44) for conventional TKA and EQ-5D 0.80±0.20 to 0.82±0.18 (p = 0.23) and WOMAC 72.71±18.52 to 75.77±17.78 (p = 0.07) for navigated TKA, respectively. Similarly, responder rates for positive outcome were comparable between trainees and senior surgeons (90.7% versus 87.0% p = 0.39 for conventional TKA, 88.7% versus 89.4% p = 0.80 for navigated TKA). Supervised TKA is a safe procedure during the learning curve of young orthopaedic surgeons.
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