April 10, 2018
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Fellowship-trained surgeons are more likely to perform arthroscopic vs open distal clavicle excision

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Newly trained, board-eligible orthopedic surgeons were more likely to perform arthroscopic distal clavicle excision compared to open treatment for acromioclavicular joint arthritis, according to results published in Arthroscopy.

Perspective from Sanjeev Bhatia, MD

“Incidence of open distal clavicle excision has declined among newly trained, board-eligible orthopedic surgeons, possibly due to an increased complication rate with open (vs. arthroscopic) excision,” Dean Wang, MD, co-author of the study, told Healio.com/Orthopedics. “This procedure can be done effectively through [a] modern arthroscopic technique.”

Dean Wang

Using the American Board of Orthopaedic Surgery database to find cases submitted by candidates taking part 2 of the board examination, Wang and colleagues analyzed the performance of either open (n=3,229) or arthroscopic (n=12,782) distal clavicle excision among patients with acromioclavicular joint arthritis to determine trends in annual incidence, complication rates and surgeon fellowship training.

Results showed a decrease in the overall annual incidence of open distal clavicle excision from April 2004 to September 2013. Although the annual number of arthroscopic distal clavicle excisions remained steady, researchers found an increase in the percentage of distal clavicle excisions performed arthroscopically. The open approach was more likely to be performed by surgeons without fellowship training, while the arthroscopic approach was more likely to be performed by surgeons with sports medicine training.

Compared with arthroscopic distal clavicle excision, researchers noted a higher surgical complication rate overall among patients who underwent open distal clavicle excision. Whether performing open or arthroscopic distal clavicle excision, results showed sports medicine surgeons had a lower reported surgical complication rate compared with other fellowship-trained surgeons. – by Casey Tingle

 

Disclosures: Wang reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.