Abstract
The learning curve to reach technical proficiency for third-generation percutaneous
or minimally invasive chevron and Akin osteotomies (PECA/MICA) is recognized to be
steep however it is poorly defined in the literature. This study is a retrospective
review of the first 58 consecutive PECA cases of a single surgeon. The primary outcome
was the number of cases required to reach technical proficiency as defined by the
operation time. Secondary outcomes included radiation exposure, radiographic deformity
correction, and complication rates. Between November 2017 and March 2019, 61 consecutive
PECA cases were performed with outcome data available for 58 of these (95%). Technical
proficiency was reached after 38 cases. Operation time and radiation exposure significantly
decreased after this transition point (p < .05). There was no difference in complication rate or radiographic deformity correction
regardless of position along the learning curve (p > .05). In conclusion, the mean number of cases required to reach technical proficiency
in third-generation PECA is 38 cases. The complication rate does not correlate to
the number of cases performed, therefore surgeons interested in learning minimally
invasive surgery can be reassured that there is unlikely to be an additional risk
of harm to a patient during the learning curve.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 17, 2022
Footnotes
Financial Disclosure: There was no funding to report for this study.
Conflict of Interest: Two of the authors (P.L. and M.R.W.) report personal fees unrelated to, and outside the submitted work. The other authors have no conflicts of interest to declare.
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