Effect of surgeon fatigue on hip and knee arthroplasty
Bibliographic record
Abstract
BACKGROUND: There is growing support in the literature that patient outcomes are adversely affected by physician fatigue in operator-dependent cognitive and technical tasks. Recent increases in total joint arthroplasty caseloads have resulted in longer operative days and increased surgeon fatigue. We sought to determine if time of day predicts perioperative complications and outcomes in total joint arthroplasty. METHODS: The records of all total hip and knee arthroplasties (THA; TKA) performed for primary osteoarthritis in one calendar year at one large university hospital were retrospectively reviewed. Demographic data, surgery start time and duration, intraoperative complications, radiographic component alignment and functional outcome scores (SF-12 and Western Ontario and McMaster Universities Osteoarthritis Index) were collected and analyzed using linear and nonparametric rank correlation statistics. Data were corrected for sex, body mass index, surgeon and postcall operating days. RESULTS: In the THA cohort (n=341), a later surgery start time was significantly related to duration of surgery (p= 0.004, mean difference -7.1 min). There was a trend toward significance between a later surgery start time and intraoperative femur fracture (p= 0.05). Postoperative complications, component alignment and functional outcome scores were not significantly affected by surgery start time. There were no significant findings for any of the intraoperative or postoperative outcomes in the TKA cohort (n=292). CONCLUSION: Duration of surgery and incidence of intraoperative complications for THA may increase with later surgery start time; however, the relatively small statistical differences observed imply that they likely are not clinically significant.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".