Learning curve in total hip arthroplasty

Aim: Total hip arthroplasty is a common operation but there are few data de scribing the learning curve of this operation. The aim of the presented stu dy is to prove and describe the learning curve in total hip arthroplasty. M ethod: Between 1991 and 1993, 168 patients were included in this propective study, operated by three surgeons having different experiences in operatin g total hip arthroplasty. Perioperative complications and postoperative X-r ays were analysed. Patients were re-examined clinically and radiologically and by a questionnaire 5 years after operation. Results: Radiological compl icatiops of the first 84 operated patients were statistically significantly higher than those of the following 84 patients, except for minimal bone fr actures and leg lenghtening. The learning curve of all surgeons was finishe d after 20 operations independent of their experience. Clinical resuls were not influenced by the learning curve at follow-up. Conclusions: Regardless of the experience of the surgeon, the learning curve in total hip arthropl asty is finished after about 20 operations for each surgeon. Intensive preo perative planning and exchange of experience inside and outside every clini c will shorten the length of the learning curve.