Surgeon and institution impacts on arthroplasty alignment
Research type
Research Study
Full title
Assessing surgeon and institution-based factors that impact prosthesis alignment following total joint arthroplasty.
IRAS ID
231273
Contact name
Matthew Donaldson
Contact email
Sponsor organisation
University College London Hospitals
Duration of Study in the UK
0 years, 3 months, 10 days
Research summary
Primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) are safe and effective treatments for end-stage osteoarthritis. Despite the success of arthroplasty, long-term survival leaves room for improvement. There is evidence that implant mal-alignment contributes to reduced implant survival. There are suggestions that surgeon volume and experience may contribute to implant mal-alignment, however there is little evidence addressing the surgeon or institution factors that may contriubute to mal-alignment in arthroplasty.
Our objective is to determine the impact of patient volume, surgeon experience, and institution type (teaching vs. non-teaching) on femoral tibial angle and tibial plateau angle outliers following TKA and abduction (inclination) and anteversion angles following THA.
A more thorough understanding of the how surgeon- and institution-specific factors influence mal-alignment may uncover actionable strategies for improving TJA survival. Furthermore, understanding this relationship may have implications as to where to deploy expensive but potentially alignment-improving technologies such as robotic systems and patient-specific instrumentation in the future.
The present study is a multi-centre retrospective review of post-operative radiographs conducted in conjunction with University of Washington, St Louis researchers. Post-operative xrays of patients that have undergone primary TKA or THA from 2012-2017 will de-identified then measured for alignment. Specific measurements for TKA include: Femoral tibial angle; Tibial plateau angle; Posterior slope angle. Measurements for THA include: Cup abduction angle, Cup anteversion angle. Difference in alignment in terms of percentage outliers will be compared between institution types (teaching vs non-teaching hospital), surgeon experience in terms of years post training and volume of surgeries.REC name
East of Scotland Research Ethics Service REC 2
REC reference
17/ES/0153
Date of REC Opinion
24 Nov 2017
REC opinion
Further Information Favourable Opinion