Comment: Scaling the Steep Learning Curve of Total Hip Replacement Surgery

Dr. Johnson,

Your editorial in the previous issue of the journal[1] presents excellent points about the steep learning curve of total hip replacement surgery. I agree with your well-made points.

The points you made have been recognized by some for years. The first serious proposal to do something about the canine and feline total hip replacement learning curve was presented at the World Veterinary Orthopedic Congress in Barcelona in 2018. Thanks to the American College of Veterinary Surgeons (ACVS) leadership, the American College of Veterinary Surgeons Joint Replacement Surgery (ACVS JRS) fellowship program, which evolved from that presentation, is developing to improve the situation.

The intent of the ACVS JRS fellowship program is to mimic, to some reasonable degree, the training programs of human hip replacement surgeons. The primary mentors in fellowship programs will initially be an ACVS JRS founding fellow. As the program progresses, mentees completing their program will be granted ACVS JRS fellow status and will have the opportunity to become primary mentors. Augmented training such as this is in place for oral and maxillofacial surgery, oncology surgery and minimally invasive surgery. Shortages of mentoring programs for other complex procedures may exist in other disciplines.

The ‘short courses’ you noted will likely continue at least in a similar way as our human model. Perhaps more constraints and attainment of specified levels of achievement are needed after the short courses in the veterinary profession for the well-being of animals.

You mentioned the numbers of human hip replacements in the United Kingdom that are astronomical compared with those in veterinary medicine. It would be good if the veterinary profession could ‘catch up’ to the human model with a higher case load and more intense training programs. The first JRS fellowship programs are on pace to start in 2022. These programs have the potential for surgeons-in-training to make scaling the Total Hip Replacement (THR) learning curve faster, easier and with fewer complications to improve patient outcomes. Minimum training standards are established that must be completed during fellowship training. Interested aspiring surgeons should contact the ACVS for more information.

Publication History

Received: 29 October 2021

Accepted: 30 October 2021

Article published online:
31 December 2021

• Reference

• 1 Johnson KA. Scaling the Steep Learning Curve of Total Hip Replacement Surgery. Vet Comp Orthop Traumatol 2021;34(05)