Is there a learning curve in foot and ankle surgery?

Area of Science:

• Orthopaedic Surgery
• Surgical Education
• Patient Outcomes

Background:

• Limited research exists on learning curves in foot and ankle surgery.
• Previous studies focused on technical aspects and experienced surgeons.
• This study addresses the learning curve for early-career foot and ankle surgeons.

Purpose of the Study:

• To investigate the learning curve in foot and ankle surgery during a surgeon's initial year.
• To define the learning curve based on functional patient outcomes.
• To differentiate learning curve effects across various foot and ankle sub-regions.

Main Methods:

• Analysis of 150 elective foot and ankle surgeries.
• Comparison of preoperative and 6-month postoperative functional scores.
• Stratification of patients into the first and second 6-month surgical periods.

Main Results:

• Functional improvement was notably greater in the second 6-month period (p=0.0605).
• No significant difference in functional improvement was observed for forefoot procedures (p=0.345).
• Excluding forefoot cases, functional improvement was significantly higher in the second group (p=0.0333).

Conclusions:

• A discernible learning curve exists in the first year of foot and ankle surgical practice.
• This learning curve is primarily demonstrated through functional outcome improvements.
• The learning curve effect is specific to ankle, hindfoot, and midfoot surgeries, not forefoot procedures.