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J Knee Surg 2020; 33(12): 1238-1242
DOI: 10.1055/s-0039-1692674
Original Article

Technical Obstacles for Low-Volume Surgeons in Primary Anterior Cruciate Ligament Reconstruction

Kengo Harato
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Shu Kobayashi
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Takashi Toyoda
2   Nishi Waseda Orthopaedic Surgery, Nishiwaseda Orthopedic Clinic, Tokyo, Japan
,
Takayuki Hasegawa
3   Department of Orthopedic Surgery, Saitama City Hospital, Saitama, Japan
,
Yasunori Tsukimura
4   Department of Orthopedic Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
,
Yasuo Niki 
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Abstract

A longer surgical time will lead to postoperative complications in orthopaedic surgery. According to previous reports, surgeon volume affects a surgical time in anterior cruciate ligament (ACL) reconstruction. However, little attention has been paid to difference of a surgical time between high- and low-volume surgeons in ACL reconstruction. The purpose of the present study was to investigate the surgical time for both high- and low-volume surgeons and to clarify technical obstacles as well as the important technique to reduce the surgical time in ACL reconstruction. A total of 103 knees in 103 patients with ACL tear were enrolled. All the procedures were performed by 13 different surgeons. The surgeons were divided into two surgeon groups (high- and low-volume groups) based on the number of annual cases. The operative technique was divided into the same five steps to perform comparisons of step-by-step surgical time between the surgeon groups of different volumes. The statistical comparison was done between high- and low-volume groups in terms of surgical time in each step. Total operation times were 87.8 ± 17.6 and 129.9 ± 42.9 minutes in high- and low-volume group, respectively. Low-volume surgeons took much time in tendon harvesting and bone tunnel creation using arthroscopy. Low-volume surgeons took more time for primary ACL reconstruction, especially in tendon harvesting, compared with high-volume surgeons. Tendon harvesting was extremely important, as well as bone tunnel creation, for low-volume surgeons to reduce surgical time in primary ACL reconstruction.

Keywords

anterior cruciate ligament reconstruction - low-volume surgeon - surgical - time - tendon harvesting


Publication History

Received: 04 February 2019

Accepted: 19 May 2019

Article published online:
08 July 2019

© 2020. Thieme. All rights reserved.

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