ArticleBone & joint open2026
Orthopaedic surgeons' perceptions of individual feedback from a national arthroplasty quality register : a phenomenographic study.
Article in Bone & joint open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
3 authors.
Funding
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Abstract
Aims: Our aim was to explore Swedish orthopaedic surgeons' and trainees' perceptions of receiving individual surgeon feedback following total hip arthroplasty (THA) from a national arthroplasty quality register. Methods: A qualitative study with a phenomenographic approach was conducted. Informants were strategically selected to maximize variation in perceptions, based on hospital type (according to the national arthroplasty register classification) and level of surgical experience (trainee or years since specialist certification). A total of 15 orthopaedic specialists and four trainees from 15 hospitals in Sweden were interviewed. Data were analyzed using the established seven-step phenomenographic analysis procedure. Results: Four qualitatively distinct perceptions of individual surgeon feedback from a national quality register were identified: 1) progression in the profession; 2) exposure to inaccurate criticism; 3) potential impairment of patient benefit; and 4) does not contribute to enhanced feedback for surgeons. Feedback was perceived as a means of professional development but was also considered to carry a risk of misinterpretation and unfair criticism if results were used inappropriately. Participants further expressed concern that surgeon-specific outcome reporting could shift the focus from patient benefit to performance metrics, potentially influencing patient selection and clinical decision-making. Finally, some informants questioned the need for a national feedback programme, citing existing local and organizational mechanisms that already provide meaningful feedback. Conclusion: Swedish orthopaedic surgeons and trainees hold diverse perceptions of individual surgeon feedback from a national arthroplasty quality register. Awareness of these perceptions is important when refining or designing future surgeon-specific feedback programmes. Development and refining of feedback systems should occur in close collaboration with orthopaedic surgeons to ensure clinical relevance and acceptance.
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