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The variability of surgical practice during total knee arthroplasty: results of a national survey amongst Belgian knee surgeons

S Mufty, K Brabants, Karl Almqvist and J Bellemans (2011) KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 19(10). p.1662-1668
abstract
Implant registries have been effective in detecting poorly performing implants and surgical strategies. They learn us however little about many variables that may be equally important to the final result. Today, no standards of care exist for performing total knee arthroplasties (TKA), and little is known about the variability that exists amongst surgeons performing this procedure. A questionnaire with 39 aspects regarding standard surgical routine during TKA was sent to all 112 members of the Belgian Knee Society. Surgeons were stratified according to surgical experience and surgical volume. An important number of routines were performed as standard by the majority (> 70%) of surgeons. Surgeons however significantly differed in the following aspects of the procedure: radiographic evaluation, use of minimally invasive surgery (MIS), preferred landmark for femoral component rotation, method of closure and activities allowed postoperatively. Both surgical experience and surgical volume had a significant effect, but their influence on strategies was different. Less-experienced surgeons used the posterior condylar line as their reference for femoral component rotation significantly more frequent than more-experienced surgeons and were more aggressive towards postoperative sports activities compared to more-experienced surgeons. High-volume surgeons used significantly more frequent MIS and low-volume surgeons preferred a more extensive postoperative radiographic evaluation. Data of this study show that an important number of routines are performed similarly by the majority of surgeons, and that minor but significant differences exist between high-volume versus low-volume surgeons, and between experienced versus less-experienced surgeons.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
REGISTER, Registry, REPLACEMENT, ASSOCIATION, Strategy, Surgical routine, Total knee arthroplasty
journal title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Knee Surg. Sports Traumatol. Arthrosc.
volume
19
issue
10
pages
1662 - 1668
Web of Science type
Article
Web of Science id
000295037900008
JCR category
SPORT SCIENCES
JCR impact factor
2.209 (2011)
JCR rank
17/83 (2011)
JCR quartile
1 (2011)
ISSN
0942-2056
DOI
10.1007/s00167-010-1378-8
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1944478
handle
http://hdl.handle.net/1854/LU-1944478
date created
2011-11-18 16:37:23
date last changed
2016-12-19 15:44:35
@article{1944478,
  abstract     = {Implant registries have been effective in detecting poorly performing implants and surgical strategies. They learn us however little about many variables that may be equally important to the final result. Today, no standards of care exist for performing total knee arthroplasties (TKA), and little is known about the variability that exists amongst surgeons performing this procedure. 
A questionnaire with 39 aspects regarding standard surgical routine during TKA was sent to all 112 members of the Belgian Knee Society. Surgeons were stratified according to surgical experience and surgical volume. 
An important number of routines were performed as standard by the majority ({\textrangle} 70\%) of surgeons. Surgeons however significantly differed in the following aspects of the procedure: radiographic evaluation, use of minimally invasive surgery (MIS), preferred landmark for femoral component rotation, method of closure and activities allowed postoperatively. Both surgical experience and surgical volume had a significant effect, but their influence on strategies was different. Less-experienced surgeons used the posterior condylar line as their reference for femoral component rotation significantly more frequent than more-experienced surgeons and were more aggressive towards postoperative sports activities compared to more-experienced surgeons. High-volume surgeons used significantly more frequent MIS and low-volume surgeons preferred a more extensive postoperative radiographic evaluation. 
Data of this study show that an important number of routines are performed similarly by the majority of surgeons, and that minor but significant differences exist between high-volume versus low-volume surgeons, and between experienced versus less-experienced surgeons.},
  author       = {Mufty, S and Brabants, K and Almqvist, Karl and Bellemans, J},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {REGISTER,Registry,REPLACEMENT,ASSOCIATION,Strategy,Surgical routine,Total knee arthroplasty},
  language     = {eng},
  number       = {10},
  pages        = {1662--1668},
  title        = {The variability of surgical practice during total knee arthroplasty: results of a national survey amongst Belgian knee surgeons},
  url          = {http://dx.doi.org/10.1007/s00167-010-1378-8},
  volume       = {19},
  year         = {2011},
}

Chicago
Mufty, S, K Brabants, Karl Almqvist, and J Bellemans. 2011. “The Variability of Surgical Practice During Total Knee Arthroplasty: Results of a National Survey Amongst Belgian Knee Surgeons.” Knee Surgery Sports Traumatology Arthroscopy 19 (10): 1662–1668.
APA
Mufty, S., Brabants, K., Almqvist, K., & Bellemans, J. (2011). The variability of surgical practice during total knee arthroplasty: results of a national survey amongst Belgian knee surgeons. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 19(10), 1662–1668.
Vancouver
1.
Mufty S, Brabants K, Almqvist K, Bellemans J. The variability of surgical practice during total knee arthroplasty: results of a national survey amongst Belgian knee surgeons. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2011;19(10):1662–8.
MLA
Mufty, S, K Brabants, Karl Almqvist, et al. “The Variability of Surgical Practice During Total Knee Arthroplasty: Results of a National Survey Amongst Belgian Knee Surgeons.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 19.10 (2011): 1662–1668. Print.