The Journal of Bone and Joint Surgery (American). 2007;89:1393-1398.
doi:10.2106/JBJS.F.01089
© 2007 The Journal of Bone and Joint Surgery, Inc.
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Training Resources in Arthroscopic Rotator Cuff Repair

Mark A. Vitale, MD, MPH1, Conor P. Kleweno, BSE2, Alberto M. Jacir, MD2, William N. Levine, MD2, Louis U. Bigliani, MD2 and Christopher S. Ahmad, MD2

1 New York Orthopaedic Hospital, 622 West 168th Street, PH 1132, 11th Floor, New York, NY 10032. E-mail address: mav2002{at}columbia.edu
2 Center for Shoulder, Elbow, and Sports Medicine, New York Orthopaedic Hospital, College of Physicians and Surgeons of Columbia University, 622 West 168th Street, PH 1114, New York, NY 10032

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

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 repairs.


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A. Insel, B. Carofino, R. Leger, R. Arciero, and A. D. Mazzocca
The Development of an Objective Model to Assess Arthroscopic Performance
J. Bone Joint Surg. Am., September 1, 2009; 91(9): 2287 - 2295.
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