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Hip News

Training Surgeons for New Hip Replacement Method

Zimmer, the makers of total hip implants, has a training program for surgeons. More than 500 surgeons have gone to the Zimmer Learning Institute to learn how to do a two-incision total hip replacement (THR). This new operation is part of a move toward what's called minimally invasive (MI) surgery.

With MI a much smaller opening is made in the skin. Special tools are used to insert the implant. A special X-ray called fluoroscopy lets the surgeon to see inside the joint and helps guide the operation.

As part of the training the surgeons were asked to report the results of the first 10 operations they did using the two-incision method. This study presents the findings of 159 surgeons who did 851 THRs this way. Zimmer cementless implants were used in all cases.

Data collected included patient age, gender, weight, and diagnosis. All patients had osteoarthritis or arthritis from trauma or injury. Other measures included incision length, operative time, blood loss, and problems after the surgery. The number of fractures, nerve injuries, dislocations, and infections was recorded.

The authors report four key findings:

  • Surgeons who do 50 or more THRs each year reported far fewer patient complications.
  • The rate of reported problems didn't go down during the first 10 cases using this
    method.
  • Operative time and the time it took to do fluoroscopy was less from the first to the
    10th case.
  • Overweight patients (body mass index greater than 30) were more likely to have
    problems after THR.

    Two possible problems with this study were mentioned. Surgeons made their own reports of patient complications. This means they may have underreported the number. Improved results may occur after the first 10 cases.

    Zimmer will keep collecting data from the 500 surgeons who are using a two-incision operation to insert the Zimmer implants during THRs. Training at the Zimmer Institute will be changed and improved as the results are reported.


    Michael J. Archibeck, MD, and Richard E. White, Jr., MD. Learning Curve for the Two-Incision Total Hip Replacement. In Clinical Orthopaedics and Related Research. December 2004. Vol. 429. Pp. 232-238.

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