Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 28, Issue 2 , Pages 218-224, February 2012

Diagnostic Knee Arthroscopy: A Pilot Study to Evaluate Surgical Skills

  • Michael J. Elliott, M.D.

      Affiliations

    • Department of Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
    • Department of Orthopedics, Children's Hospital Central California, Madera, California, U.S.A.
    • Corresponding Author InformationAddress correspondence to Michael J. Elliott, M.D., Department of Orthopedics, Children's Hospital Central California, 9300 Valley Children's Place, Madera, CA 93636, U.S.A.
    • ,
  • Peter A. Caprise, M.D.

      Affiliations

    • The Orthopaedic Center of Central Virginia, Lynchburg, Virginia, U.S.A.
    • ,
  • Amy E. Henning, D.O.

      Affiliations

    • Medical Corps, US Navy, Portsmouth, Virginia, U.S.A.
    • Bone and Joint/Sports Medicine Institute, Portsmouth, Virginia, U.S.A.
    • Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.
    • ,
  • Christopher A. Kurtz, M.D.

      Affiliations

    • Medical Corps, US Navy, Portsmouth, Virginia, U.S.A.
    • Division of Sports Medicine, Department of Orthopaedic Surgery, Bone and Joint/Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.
    • Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A.
    • ,
  • Jon K. Sekiya, M.D.

      Affiliations

    • MedSport–Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.

Received 21 February 2011; accepted 27 July 2011. published online 31 October 2011.

Purpose

To develop a scoring system to evaluate individual proficiency at diagnostic knee arthroscopy.

Methods

This was a prospective blinded study. Subjects included residents in postgraduate year (PGY) 1 through PGY 5 (n = 20) and staff surgeons (n = 10). All subjects performed a diagnostic arthroscopy on a cadaveric knee. Subjects were evaluated on both completeness and time required to complete the arthroscopy. The examiner viewed the arthroscopy from a remote location and was blinded to the level of training of the subjects. During the arthroscopy, 15 areas required assessment to achieve a score of 75 points. An additional 25 points were awarded depending on the time it took to complete the arthroscopy. A maximum of 100 points were available (Total score = Arthroscopy score + Time score).

Results

Thirty subjects were divided into 3 groups: group 1 (PGY 1 or 2) (n = 12), group 2 (PGY 3, 4, or 5) (n = 8), and group 3 (staff) (n = 10). In group 1 the mean total score was 28.25 points, the mean time to complete arthroscopy was 11.9 minutes, and the mean number of structures not examined was 8.67. In group 2 the mean total score was 76 points, the mean time to complete arthroscopy was 8.2 minutes, and the mean number of structures not examined was 1.75. In group 3 the mean total score was 100 points, the mean time to complete arthroscopy was 4.6 minutes, and the mean number of structures not examined was 0. Statistically significant differences by use of an analysis of variance test were noted for the total score, total time, and number of missed structures (P < .001).

Conclusions

Using our skills assessment tool, we were able to evaluate subjects and determine their relative technical skill level in performing a diagnostic arthroscopy. This tool was able to distinguish among the novice, experienced, and expert levels in performing diagnostic arthroscopy.

Level of Evidence

Level III, development of diagnostic criteria on the basis of consecutive subjects.

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 The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. The authors report no conflict of interest.

 This is a U.S. government work. There are no restrictions on its use.

PII: S0749-8063(11)00995-9

doi:10.1016/j.arthro.2011.07.018

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 28, Issue 2 , Pages 218-224, February 2012

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