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).
Conclusion: The information from this survey may be used to direct
the continually evolving training of surgeons in arthroscopic rotator cuff