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Use of the cumulative summation technique to quantitatively assess a surgical learning curve: canine total hip replacement.

OBJECTIVE
To quantitatively assess a surgical "learning curve" using the cumulative summation (CUSUM) score technique.


STUDY DESIGN
Application of a CUSUM technique to a consecutive series of surgical cases.


ANIMALS
Consecutive primary cemented total hip replacement (THR; n=116) in 106 dogs.


METHODS
Records of all dogs that had primary canine THR were reviewed. Data retrieved included date of surgery, postoperative complications, and duration of follow-up. The 12-week outcome was analyzed graphically and with a CUSUM technique.


RESULTS
One hundred and one (87%) procedures were "successful" and 15 (13%) developed major complications within 12 weeks (failures). The CUSUM chart clearly demonstrated an initial "learning curve" of ∼44 THR.


CONCLUSION
The CUSUM technique can be used to demonstrate the learning curve for canine THR surgery.