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Orthopaedic Surgery Sports Medicine Fellows See Substantial Increase in Hip Arthroscopy Procedural Volume With High Variability From 2011 to 2016

  • Adam M. Gordon
    Affiliations
    Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A.
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  • David C. Flanigan
    Affiliations
    Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A.
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  • Azeem Tariq Malik
    Affiliations
    Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A.
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  • William Vasileff
    Correspondence
    Address correspondence to William Vasileff, M.D., Department of Orthopaedics, Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Dr., Columbus, OH 43202.
    Affiliations
    Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A.
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Published:October 03, 2020DOI:https://doi.org/10.1016/j.arthro.2020.09.043

      Purpose

      To analyze the trends in operative experience, specifically procedures of the shoulder, hip and knee, of fellows graduating from Accreditation Council for Graduate Medical Education orthopaedic sports medicine fellowships between 2011 and 2016.

      Methods

      The 2011-2016 Accreditation Council for Graduate Medical Education orthopaedic surgery sports medicine fellow case logs were retrieved for analysis. Trends in the mean case volume for procedures of the shoulder, hip, and knee were analyzed. Linear regression was used to identify significant changes in trends over time for each surgical case/procedure. Variation in case volume between fellows in the lowest (10th) and highest (90th) centile was assessed for first and last year of the study.

      Results

      The average number of total procedures per fellow minimally decreased by 3.5% from 2011 to 2016 (726 to 701 cases) (P < .001). The mean total number of hip procedures significantly increased by 155% from 24.9 to 63.5 (P = .049). There were no significant differences in the mean total number of shoulder (P = .88) and knee procedures (P = .54). Arthroscopic hip procedures had the largest increase from 2011 to 2016 (14.1 to 57.8 [+310%], P = .049). There was greater than 2-fold difference in total procedural volume between fellows in the 10th and 90th percentile for 2011 and 2016, with the greatest variation (64-fold) for arthroscopic hip procedures.

      Conclusions

      In this study there was a 2.6-fold increase in hip procedures, largely driven by a 310% rise in arthroscopic hip cases. The average procedural volume per fellow minimally decreased, with no change in the mean number of shoulder and knee procedures.

      Clinical Relevance

      Understanding variability in case exposure among orthopaedic sports medicine fellowships is important for programs to ensure that fellows are appropriately exposed to all facets of sports medicine procedures.
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