关节镜下肩袖修补术的培训资源

Training resources in arthroscopic rotator cuff repair.

作者信息

Vitale Mark A, Kleweno Conor P, Jacir Alberto M, Levine William N, Bigliani Louis U, Ahmad Christopher S

机构信息

New York Orthopaedic Hospital, 622 West 168th Street, PH 1132, 11th Floor, New York, NY 10032, USA.

出版信息

J Bone Joint Surg Am. 2007 Jun;89(6):1393-8. doi: 10.2106/JBJS.F.01089.

DOI:10.2106/JBJS.F.01089

PMID:17545443

Abstract

BACKGROUND

All-arthroscopic rotator cuff repair is becoming more commonly performed with recent improvements in implants, instrumentation, and techniques. This study evaluated the influence of different training resources for surgeons performing this procedure.

METHODS

A twenty-eight-item survey was created to evaluate the methods by which orthopaedic surgeons are trained in the skill of all-arthroscopic rotator cuff repair. We selected 2455 surgeons from the American Academy of Orthopaedic Surgeons web site who indicated that they performed shoulder surgery, arthroscopic surgery, and/or sports medicine as part of their practice. Using a 5-point Likert scale, the respondents rated the relative importance of different training resources, including the completion of a sports medicine or shoulder surgery fellowship, attendance at instructional courses, and practice on shoulder models, in contributing to their ability to perform arthroscopic rotator cuff repair.

RESULTS

Of the 2455 surveys sent, 1076 were returned (a response rate of 43.8%). Significantly more surgeons indicated that they performed arthroscopic repairs for a 2-cm tear compared with a 5-cm tear (p < 0.001). A younger age, higher volume of shoulder arthroscopies, and higher volume of rotator cuff repairs were all associated with significantly higher rates of preference for all-arthroscopic repairs compared with other types of repairs (p < 0.001). Compared with surgeons who received training in shoulder surgery during residency only, surgeons who had completed either shoulder or sports medicine fellowships were more likely to perform all-arthroscopic repairs. When ranking the relative importance of resources in the training for all-arthroscopic repair, the overall Likert scale scores were highest for a sports medicine fellowship (3.49), hands-on instructional courses (3.33), and practice in an arthroscopy laboratory on cadaver specimens (3.22). Likert scores were lowest for residency training (2.02), practice on artificial shoulder models (2.13), and Internet resources (2.25).

CONCLUSION

The information from this survey may be used to direct the continually evolving training of surgeons in arthroscopic rotator cuff repairs.

摘要

背景

随着植入物、器械和技术的不断改进，全关节镜下肩袖修复术的开展越来越普遍。本研究评估了不同培训资源对实施该手术的外科医生的影响。

方法

设计了一项包含28个条目的调查问卷，以评估骨科医生在全关节镜下肩袖修复技术方面的培训方法。我们从美国骨科医师学会网站上选取了2455名外科医生，他们表示自己在执业过程中进行肩部手术、关节镜手术和/或运动医学相关手术。受访者使用5级李克特量表对不同培训资源的相对重要性进行评分，这些资源包括完成运动医学或肩部手术进修、参加教学课程以及在肩部模型上练习，评估这些资源对他们进行关节镜下肩袖修复能力的贡献。

结果

在发放的2455份调查问卷中，有1076份被收回（回复率为43.8%）。与5厘米撕裂伤相比，明显更多的外科医生表示他们会对2厘米撕裂伤进行关节镜修复（p < 0.001）。与其他类型的修复相比，年龄较轻、肩部关节镜手术量较高以及肩袖修复量较高，都与全关节镜修复的偏好率显著更高相关（p < 0.001）。与仅在住院医师培训期间接受肩部手术培训的外科医生相比，完成肩部或运动医学进修的外科医生更有可能进行全关节镜修复。在对全关节镜修复培训中资源的相对重要性进行排名时，运动医学进修的总体李克特量表得分最高（3.49），实践教学课程（3.33）以及在关节镜实验室对尸体标本进行练习（3.22）。住院医师培训（2.02）、在人工肩部模型上练习（2.13）和互联网资源（2.25）的李克特得分最低。