Abstract Perspective: Trainee performed total knee arthroplasty is safe and effective: A systematic review and meta-analysis comparing outcomes between trainees and consultants


“In an era of increasing scrutiny on outcomes and pressures on efficiency, we wanted to ask: is the traditional apprenticeship model of training in knee arthroplasty safe and effective? We performed a systematic review and meta-analysis identifying 9 studies where trainees had performed part or all of the procedure. Our primary outcome was revision surgery and we included a host of secondary outcomes also. Our findings were reassuring for surgeons, trainees and patients. There was no significant difference in the rate of revision, neurological deficit, transfusion rate, thrombosis or operation time. Consultants performed slightly better with regards to functional outcome, but this was well within established minimum clinically important differences. There is likely to be a high degree of selection bias with respect to the case complexity between consultants and trainees. As such, we can conclude overall that in selected cases, consultant supervised knee arthroplasty performed by trainees is safe, with no adverse impact on outcome or clinically important function.”

Dr. Suroosh Madanipour, study author