Training resources in arthroscopic rotator cuff repair.
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).


CONCLUSIONS
The information from this survey may be used to direct the continually evolving training of surgeons in arthroscopic rotator cuff repairs.
Vitale
Mark A
MA
New York Orthopaedic Hospital, 622 West 168th Street, PH 1132, 11th Floor, New York, NY 10032, USA. mav2002@columbia.edu
Kleweno
Conor P
CP
Jacir
Alberto M
AM
Levine
William N
WN
Bigliani
Louis U
LU
Ahmad
Christopher S
CS
D001182:Arthroscopy; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D005257:Fellowships and Scholarships; D006801:Humans; D009985:Orthopedics / Q000193:education*; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013178:Sports Medicine / Q000193:education