The Learning Curve and Its Teachings

Abstract

The learning curve is often used to explain a failure, more rarely for improve the results. In a retrospective study of 150 consecutive revisions of total hip prostheses, 2 chronological groups of 75 patients (groups 1 and 2) were identified to assess the evolution of the strategic choices and the results. The better results of the patients in group 2 could indicate that there is a correlation between the strategic choice, the quality of a surgical procedure and the final result; but it must still be also noted that the initial bone stock is less affected in group 2, and the number of cases with an osteoporosis rated as poor is smaller.

In the end, the following three events can have an impact on a radiographic result (secondary bone stock and secondary stability): (1) The type of primary stability, good reflection of the strategic choice and the surgical technique adopted by the surgeon (2)The degree of osteoporosis, good reflection of the “bone condition” of the patient (3) The value of the initial bone stock good reflection of the bone defects caused by loosening (and/or the surgeon!).