The learning curve for hip arthroscopy: a systematic review
Daniel J Hoppe1, Darren de Sa1, Nicole Simunovic2
1Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario.
Summary
The learning curve for hip arthroscopy is steep, with 30 cases often used as a benchmark. While operative time and complication rates improve, evidence is insufficient to validate a specific number of cases for proficiency.
Area of Science:
- Orthopedic Surgery
- Surgical Education
Background:
- The learning curve for hip arthroscopy is widely considered steep.
- Quantifying proficiency in hip arthroscopy is crucial for patient safety and surgical outcomes.
Purpose of the Study:
- To systematically review and identify reported learning curves for hip arthroscopy.
- To examine the evidence supporting these learning curves.
- To determine if current evidence validates a specific number of cases for achieving proficiency in hip arthroscopy.
Main Methods:
- A systematic review of Embase and Medline databases was conducted.
- Included studies reporting learning curves in hip arthroscopy.
- Quality assessment and descriptive statistics were compiled for eligible studies.
Main Results:
- Six studies encompassing 1,063 patients were identified.
- Thirty cases was the most common cutoff to distinguish early vs. late surgical experience.
- Five of six studies demonstrated improved operative times and reduced complication rates in later cases.
Conclusions:
- A 30-case threshold shows improvements in operative time and complication rates for hip arthroscopy.
- Insufficient evidence exists to definitively quantify the hip arthroscopy learning curve or validate 30 cases as the proficiency benchmark.
- The 30-case benchmark should be interpreted with caution due to limited evidence.
