Wrist and Hand Arthroscopy Procedure Volume Is Low Among Graduating Orthopaedic Surgery Residents

Abstract

Purpose

To evaluate orthopaedic resident case volume and case log variability for wrist and hand arthroscopy.

Methods

The Accreditation Council for Graduate Medical Education surgical case log data from 2016 to 2020 for graduating United States orthopaedic surgery residents was assessed. Arthroscopy procedures of the wrist and hand were categorized. The average number of cases performed per resident was compared from 2016 to 2020 to determine the percent change in case volume. The 10th, 30th, 50th, 70th, and 90th percentiles of case volumes from 2016 to 2020 were presented to demonstrate case volume variability.

Results

The average number of total arthroscopic wrist and hand procedures performed per resident was 4.6 ± 5 (3, 0-44) in 2016, which decreased to 3 ± 3 in 2020 (2, 0-25), representing a 34.8% decrease (P < .001). The average number of total arthroscopic wrist and hand procedures performed by the 10th and 90th percentile of residents was 0 and 10 in 2016 and 0 and 7 in 2020, representing a large degree of case log variability. About 1 in 10 graduating orthopaedic surgery residents performed only a single wrist and hand arthroscopy case each year, and half performed 3 cases or fewer.

Conclusions

Orthopaedic graduate medical education exposure to wrist and hand arthroscopy remains low and highly variable, despite increasing use of arthroscopy in wrist procedures.

Clinical Relevance

It is important to evaluate the procedural case volume for wrist and hand arthroscopy among orthopaedic surgery residents. With information from this study, we may be able to suggest changes, such as the implementation of case minimums, that provide better opportunities for orthopaedic trainees to enhance proficiency and improve patient care in this area.