Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A.
Department of Orthopaedics, The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, U.S.A..
Arthroscopy. 2021 Feb;37(2):521-527. doi: 10.1016/j.arthro.2020.09.043. Epub 2020 Oct 3.
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.
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.
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.
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.
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.
分析 2011 年至 2016 年期间，通过美国毕业后医学教育认证委员会（ACGME）认证的骨科运动医学住院医师培训计划毕业的住院医师的手术经验趋势，特别是肩部、臀部和膝关节手术。
检索了 2011 年至 2016 年美国毕业后医学教育认证委员会骨科运动医学住院医师病例记录，分析了肩部、臀部和膝关节手术的平均手术量趋势。使用线性回归来确定每种手术程序随时间的趋势的显著变化。评估研究第一年和最后一年中，排名最低（第 10 百分位）和最高（第 90 百分位）的住院医师之间病例量的差异。
每位住院医师的总手术量平均每年减少 3.5%，从 2011 年的 726 例减少到 2016 年的 701 例（P<.001）。髋部手术的平均总数从 2011 年的 24.9 例增加到 2016 年的 63.5 例，增加了 155%（P=.049）。肩部（P=.88）和膝关节（P=.54）手术的总数无显著差异。关节镜下髋关节手术从 2011 年到 2016 年增加了 310%，增幅最大（从 14.1 例增加到 57.8 例，P=.049）。在 2011 年和 2016 年，排名第 10 百分位和第 90 百分位的住院医师之间的总手术量差异超过 2 倍，其中关节镜下髋关节手术的差异最大（64 倍）。
在这项研究中，髋关节手术增加了 2.6 倍，主要是由于关节镜下髋关节手术增加了 310%。每位住院医师的平均手术量略有减少，肩部和膝关节手术的平均数量没有变化。
了解骨科运动医学住院医师培训计划之间的病例暴露差异对于确保住院医师接受运动医学手术的各个方面的适当暴露非常重要。
