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- Talk
- UK
Are We Getting Better at What We Do? … OR Improving Revision Rates with Time
Description
The presentation given by Tim Wilton explores the evolution of surgical outcomes, particularly focusing on knee and hip replacements over the past two decades. Tim opens by questioning whether surgical proficiency is genuinely improving, as evidenced by revision rates, and acknowledges contributions from colleagues in preparing data for the discussion. He highlights findings from the Swedish Registry, demonstrating marked improvements in total knee replacement results, while indicating that unicompartmental knee replacement outcomes have lagged behind despite a significant increase in surgeries over the years.
Tim introduces the concept of "cohort effect," which refers to variations in surgical outcomes influenced by factors such as demographic changes, surgical practices, implant selection, and data collection methods. He asserts that a comparative analysis of data can reveal more about trends in revision rates over time and emphasizes the importance of examining yearly cohorts rather than aggregated five-year periods.
The discussion presents graphical evidence to illustrate trends in revision rates, demonstrating both improved outcomes in some categories while noting more erratic data in others, particularly in resurfacing procedures. Tim emphasizes the relevance of learning from different implant choices and their performance over time, encouraging the orthopedic community to consider these improvements critically.
Key findings suggest that while hip replacements reveal a complex interplay of improvement and stagnation, knee replacements—especially unicompartmental types—show a pronounced decrease in revision rates over time. Tim concludes by acknowledging the multitude of factors that may influence these trends, underscoring the importance of continuous learning and adaptation within surgical practices.