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Arthroscopic rotator cuff repair: the learning curve
Dan Guttmann1, Robert D Graham, Megan J MacLennan
1Taos Orthopaedic Institute Research Foundation Taos, New Mexico 87571, USA.
Summary
Surgeons achieve proficiency in arthroscopic rotator cuff repair (ARCR) as operative time significantly decreases within the first 20 cases. This learning curve quantifies surgical skill acquisition for ARCR.
Area of Science:
- Orthopaedic Surgery
- Surgical Education
- Biomedical Engineering
Background:
- Arthroscopic rotator cuff repair (ARCR) is a complex procedure requiring significant surgical skill.
- Quantifying the learning curve for ARCR is essential for establishing proficiency benchmarks.
Purpose of the Study:
- To determine the number of cases required for a surgeon to achieve proficiency in ARCR.
- To quantitatively assess the learning curve through operative time reduction.
Main Methods:
- A prospective case series of 100 consecutive ARCR procedures performed by a single surgeon.
- Rotator cuff repair time (RCRT) was recorded for each case.
- Mean RCRTs were analyzed in blocks of 10 cases to generate a learning curve using logarithmic trend and linear regression analysis.
Main Results:
- A significant decrease in mean RCRT was observed between the first and second blocks of 10 cases (P < .05).
- The learning curve demonstrated a substantial decrease in operative time within the initial 20 cases.
- No significant differences in RCRT were found based on rotator cuff tear size.
Conclusions:
- The learning curve for ARCR, represented by RCRT over case number, quantitatively demonstrates skill acquisition.
- This study provides a benchmark for orthopaedic surgeons to anticipate the time required to attain proficiency in ARCR.