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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Article info
Publication history
Published online: October 03, 2020
Accepted:
September 23,
2020
Received:
May 7,
2020
See commentary on page 528Footnotes
The authors report the following potential conflicts of interest or sources of funding: D.C.F. reports grants and other from Smith & Nephew, other from Depuy Mitek, grants and other from Zimmer Biomet, grants and other from Vericel, other from MTF, other from KCRN, other from Hyalex, grants and other from CartiHeal, grants and other from Anika Therapeutics, grants and other from Aesculap, and grants and other from Moximed, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2020 by the Arthroscopy Association of North America
