Association between surgeon training grade and the risk of revision following total knee replacement: An analysis of National Joint Registry data

Trainees in England and Wales achieve safe and acceptable all-cause TKR implant survival, with comparable outcomes to consultants. However, adjusted analyses suggest an association between trainee-performed TKR and a small increase in the risk of early all-cause revision. This association may be attributable to factors including aseptic loosening, infection, and progression of OA. Current training practices for TKR in England and Wales are safe in terms of equivalence of all-cause implant survival to consultant-performed TKR, but we have identified areas for potential improvement in trainee outcomes.

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Publication Details

Journal
PLoS Medicine
Published
2025-08-12
DOI
https://doi.org/10.1371/journal.pmed.1004685
Citations
1
Primary Topic
Total Knee Arthroplasty Outcomes
Type
article
Field-Weighted Citation Impact
2.01

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article

Association between surgeon training grade and the risk of revision following total knee replacement: An analysis of National Joint Registry data

Timothy Fowler, Nick Howells, Ashley Blom, Michael Richard Whitehouse et al.
1 citations
PLoS Medicine
Total Knee Arthroplasty Outcomes
2.01
article

Association between surgeon training grade and the risk of revision following total knee replacement: An analysis of National Joint Registry data

Timothy Fowler, Nick Howells, Ashley Blom, Michael Richard Whitehouse, Adrian Sayers
article en
1 citations

Abstract

Trainees in England and Wales achieve safe and acceptable all-cause TKR implant survival, with comparable outcomes to consultants. However, adjusted analyses suggest an association between trainee-performed TKR and a small increase in the risk of early all-cause revision. This association may be attributable to factors including aseptic loosening, infection, and progression of OA. Current training practices for TKR in England and Wales are safe in terms of equivalence of all-cause implant survival to consultant-performed TKR, but we have identified areas for potential improvement in trainee outcomes.

PLoS MedicineVol. 22(8)
University Hospitals Bristol NHS Foundation Trust (GB), Southmead Hospital (GB), University of Manchester (GB), National Institute for Health and Care Research (GB), University of Bristol (GB)
NIHR Bristol Biomedical Research Centre, Medical Research Council
Openalex Percentile: Top 13%
Total Knee Arthroplasty Outcomes
2.01
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