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Evaluating Basic Knee Arthroscopy Skills in Orthopaedic Trainees in a Limited-Resource Setting.

Kirsty Berry1, Richard von Bormann2, Stephen Roche3

  • 1Registrar University of Cape Town, Orthopaedic Registrar University of Cape Town, South Africa.

JB & JS Open Access
|January 26, 2023
PubMed
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Orthopaedic trainees in Southern Africa show knee arthroscopy skills comparable to international standards. However, significant variability in competency necessitates improved training and consistent skill assessment for better surgical outcomes.

Area of Science:

  • Orthopaedic Surgery
  • Surgical Education
  • Medical Training

Background:

  • Orthopaedic training in Southern Africa traditionally emphasizes trauma surgery.
  • There's a growing need for elective procedures like knee arthroscopy, particularly in the private sector.
  • Assessing arthroscopic competency in resource-limited settings is crucial for surgical training.

Purpose of the Study:

  • To evaluate the arthroscopic surgical competency of orthopaedic trainees in Southern Africa.
  • To identify areas for improvement in arthroscopic skill acquisition and transfer.

Main Methods:

  • A prospective observational cohort study design was employed.
  • Orthopaedic trainees performed basic knee arthroscopy on a knee model.
  • Surgical competency was assessed using the modified Basic Knee Arthroscopy Skill Scoring System (mBAKSSS).

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Main Results:

  • Sixteen trainees (12 male, median age 36) participated.
  • The median mBAKSSS score was 28.0, with significant variability (12.0-42.5).
  • High reliability was observed for the assessment tool (Cronbach's alpha = 0.91, ICC = 0.91).

Conclusions:

  • Trainee knee arthroscopy proficiency is comparable to international benchmarks.
  • Considerable variability and inconsistency in skills among trainees were identified.
  • Enhanced, reproducible training, procedural exposure, and continuous assessment are recommended.