A recent study of anterior cruciate ligament (ACL) surgery outcomes demonstrates that doctors who regularly perform ACL reconstructions achieve better outcomes with more experience. The more than 100,000 ACL surgeries performed every year provided a broad pool for the study, which drew from data from New York's Department of Health database. The study was presented before the American Academy of Orthopedic Surgeons.
While researchers expected the trend, the results are striking. Patients in a surgeon's first 10 ACL repair procedures were five times more likely to need another repair within a year than were patients of surgeons with over 150 procedures of experience. A surgeon's first 60 ACL reconstructions are four times more likely to require another ACL procedure. In other words, a patient's likelihood of needing another procedure varied from about 1 percent to 5 percent depending on the surgeon's experience.
Inexperienced surgeons are more likely to miss other injured ligaments or improperly place or secure grafts, often leading to complications. As they gain experience, practice allows them to avoid common mistakes and oversights.
The study confirms that the learning curve of ACL surgeons has a real effect on patient health. As with any complex task, more experienced surgeons produce, on average, better health outcomes.
Researchers and medical professionals commenting on the study suggested that the same learning curve and disparity in health outcomes likely exists in other surgery specialties. To address the higher probability of mistakes and malpractice by inexperienced surgeons, they recommended more supervised training surgeries and simulation training. Interestingly, whether a surgeon had done a subspecialty fellowship didn't have much of an effect on the learning curve.
Source: "A Learning Curve For Surgeons Doing ACL Repairs," Wall Street Journal, 2/9/12