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The number of arthroscopies performed by trainees does not deduce the level of their arthroscopic proficiency

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

It is reasonable to question whether the case volume is a suitable proxy for the manual competence of an arthroscopic surgeon. The aim of this study was to evaluate the correlation between the number of arthroscopies previously performed and the arthroscopic skills acquired using a standardized simulator test.

Methods

A total of 97 resident and early orthopaedic surgeons who participated in arthroscopic simulator training courses were divided into five groups based on their self-reported number of arthroscopic surgeries: (1) none, (2) < 10, (3) 10 to 19, (4) 20 to 39 and (5) 40 to 100. Arthroscopic manual skills were evaluated with a simulator by means of the diagnostic arthroscopy skill score (DASS) before and after training. Seventy-five points out of 100 must be achieved to pass the test.

Results

In the pretest, only three trainees in group 5 passed the arthroscopic skill test, and all other participants failed. Group 5 (57 ± 17 points; n = 17) scored significantly higher than the other groups (group 1: 30 ± 14, n = 20; group 2: 35 ± 14, n = 24; group 3: 35 ± 18, n = 23; and group 4: 33 ± 17, n = 13). After a two-day simulator training, trainees showed a significant increase in performance. In group 5, participants scored 81 ± 17 points, which was significantly higher than the other groups (group 1: 75 ± 16; group 2: 75 ± 14; group 3: 69 ± 15; and group 4: 73 ± 13). While self-reported arthroscopic procedures were n.s. associated with higher log odds of passing the test (p = 0.423), the points scored in the pretest were found to be a good predictor of whether a trainee would pass the test (p < 0.05). A positive correlation was observed between the points scored in the pretest and the posttest (p < 0.05, r = 0.59, r2 = 0.34).

Conclusions

The number of previously performed arthroscopies is not a reliable indicator of the skills level of orthopaedic residents. A reasonable alternative in the future would be to verify arthroscopic proficiency on the simulator by means of a score as a pass–fail examination.

Level of evidence

III.

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Data availability

The raw data are available upon request to the corresponding author.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Orthopädische Gemeinschaftspraxis am OEZ, Hanauer Str. 65, 80993, Munich, Germany

    Hermann Anetzberger

  2. Zentrum für Gelenkchirurgie im MVZ am Nordbad, Schleißheimer Straße 130, 80797, Munich, Germany

    Andreas Kugler

  3. Gelenk.Bonn, Bonner Talweg 61, 53113, Bonn, Germany

    Dominik John

  4. Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Brandenburg der Medizinischen Hochschule Brandenburg Theodor Fontane, Hochstraße 29, 14770, Brandenburg an der Havel, Germany

    Sebastian Kopf & Roland Becker

  5. Orthopädische Klinik König-Ludwig-Haus, Brettreichstraße 11, 97074, Würzburg, Germany

    Stephan Reppenhagen

Authors
  1. Hermann Anetzberger
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  2. Andreas Kugler
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  4. Sebastian Kopf
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  5. Roland Becker
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  6. Stephan Reppenhagen
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Contributions

HA and SR conceived and designed the study. RB and SK revised the manuscript critically for intellectual content. DJ and AK designed the study and collected the data. RB gave the final approval of the manuscript.

Corresponding author

Correspondence to Hermann Anetzberger.

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The authors declare that they have no conflict of interest.

Ethical approval

The current study was approved by the ethical committee of the Bavarian State Chamber of Physicians (BLÄK) (approval number 2022-1210).

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Anetzberger, H., Kugler, A., John, D. et al. The number of arthroscopies performed by trainees does not deduce the level of their arthroscopic proficiency. Knee Surg Sports Traumatol Arthrosc 31, 4231–4238 (2023). https://doi.org/10.1007/s00167-023-07471-3

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  • DOI: https://doi.org/10.1007/s00167-023-07471-3

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