Knee Fellowships Improve Clinical Practice and Scientific Activity

Abstract

Purpose: To determine the benefits of completing a knee fellowship for orthopaedic surgeons specializing in the treatment of sports injuries.

Methods: An online survey was conducted to assess changes in clinical practice, and scientific activity in knee surgery, with special focus on the anterior cruciate ligament (ACL) before and after a knee fellowship.

Results: A total of 74 of 102 (72.54%) fellows completed the survey. The mean age of the respondents was 36.85 ± 5.0 years (range 28-47 years). Sixty-nine (93.24%) were male, and 5 were female (6.75%). Before the fellowship, only 6 (8.10%) surgeons had performed more than 50 ACL surgeries yearly as the first operator, whereas more than 60% (46) had performed fewer than 10 ACL surgeries; after the fellowship, more than 50% (41) of the surgeons performed more than 50 ACL surgeries yearly as the first operator (P < .001). Before the fellowship, 57 (77.02%) surgeons did not perform anterolateral procedures or performed in less than 20% of their cases, whereas after the fellowship, almost 40% (31) performed anterolateral procedures in most of their cases (P < .001). A significant increase was also noted in the number of publications developed during the fellowship and conference presentations given between the period before and after the fellowship (P < .001). More than 90% (70%-94.59%) answered that they would do the fellowship again.

Conclusions: Knee fellowships in highly specialized centers improve surgical activity in terms of surgical procedures and scientific production; furthermore, almost all the fellows reported that they would pursue such a fellowship again.

Clinical relevance: The results of this study may provide fellowship directors with important feedback about the strengths and weaknesses of the experience from participants.

Fig 1

The bar graph shows the number of ACL surgery performed as first operator before (blue bar) and after (orange bar) the fellowship yearly (x-axis) by the fellows (y-axis). P < .05 = statistical significant value. (ACL, anterior cruciate ligament.)

Fig 2

The bar graph shows the difference of femoral fixation system used before (blue bar) and after (orange bar) the fellowship (x-axis) by the fellows (y-axis). P < .05 = statistical significant value.

Fig 3

The bar graph shows the percentage of anterolateral procedures performed before (blue bar) and after (orange bar) the fellowship (x-axis) by the fellows (y-axis). P < .05 = statistical significant value.

Fig 4

The bar graph shows the number of publications indexed in PubMed before (blue bar) and after (orange bar) the fellowship (x-axis) by the fellows (y-axis). P < .05 = statistical significant value.

Fig 5

The bar graph shows number of conference presentations given before (blue bar) and after (orange bar) the fellowship (x-axis) by the fellows (y-axis). P < .05 = statistical significant value.