OBJECTIVES: To examine national practice, and variations in practice, concerning total hip replacement; in particular the choice of prosthesis and the involvement of consultants in NHS operations.
DESIGN: Pre-operative survey of patients undergoing total hip replacement.
SETTING: Five English regions serving combined population of 16.8 million people.
SUBJECTS: 13,343 total hip replacement operations in one year commencing September 1996, either in NHS or private sector.
MAIN OUTCOME MEASURES: Prosthesis used for surgery, status of surgeons involved in operation, use of laminar flow operating theatre.
RESULTS: Prostheses without well documented 5-year survival were used in 5504 (58%) of 9417 operations for which information was available. The consultant was the operator in 4810 (64%) of 7499 NHS operations. In 1352 trainee-led operations, the consultant was present for only 637 (47%); this figure was 54% for trainees in years 1-4 of their training. Substantial variation between NHS consultant firms occurred both for use of prostheses with well documented survival data, and supervision of trainees by the consultant.
CONCLUSIONS: This large study is the first attempt to describe national practice for primary total hip replacement. Substantial variation among consultant firms was observed for all indices of practice reported.
|Number of pages||7|
|Journal||Annals of the Royal College of Surgeons of England|
|Publication status||Published - May 2001|
- BTC (Bristol Trials Centre)
- Centre for Surgical Research
- Arthroplasty, Replacement, Hip
- Clinical Competence
- Decision Making
- Health Care Surveys
- Hip Prosthesis
- Medical Staff, Hospital
- Middle Aged
- Physician's Practice Patterns
- Postoperative Complications