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Orthop J Sports Med. 2018 Dec 20;6(12):2325967118816293. doi: 10.1177/2325967118816293. eCollection 2018 Dec.

Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients.

Author information

Midwestern Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.
Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California, USA.



Shoulder arthroscopy is a commonly performed, critical component of orthopaedic residency training. However, it is unclear whether there are additional risks to patients in cases associated with resident involvement.


To compare shoulder arthroscopy cases with and without resident involvement via a large, prospectively maintained national surgical registry to characterize perioperative risks.

Study Design:

Cohort study; Level of evidence, 3.


The prospectively maintained American College of Surgeons National Surgical Quality Improvement Program registry was queried to identify patients who underwent 1 of 12 shoulder arthroscopy procedures from 2005 through 2012. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts.


A total of 15,774 patients with shoulder arthroscopy were included in the study, and 12.3% of these had a resident involved with the case. The overall rate of adverse events was 1.09%. On multivariate analysis, resident involvement was not associated with increased rates of any aggregate or individual adverse event. There was also no association between resident involvement and risk of readmission within 30 days. Resident involvement was not associated with any difference in operative time (P = .219).


Resident involvement in shoulder arthroscopy was not associated with increased risk of adverse events, increased operative time, or readmission within 30 days. The results of this study suggest that resident involvement in shoulder arthroscopy cases is a safe method for trainees to learn these procedures.


NSQIP; adverse events; complications; graduate medical education; operative time; readmission rate; resident training; shoulder arthroscopy

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.R.B. has received hospitality payments from Smith & Nephew. A.A.R. receives royalties from, is a consultant for, and has received hospitality payments from Arthrex. N.N.V. is a paid speaker/presenter for Pacira Pharmaceuticals and receives royalties from, is a consultant for, and receives hospitality payments from Smith & Nephew. B.J.C. receives research support from Aesculap/B. Braun, Arthrex, Geistlich, Medipost, the National Institutes of Health (National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute of Child Health and Human Development), Norvartis, Sanofi-Aventis, and Zimmer; is a consultant for Anika Therapeutic, Arthrex, Bioventus, Flexion, Genzyme, Regentis, Pacira Pharmaceuticals, Smith & Nephew, Zimmer, and Vericel; has stock/stock options in Aqua Boom, Biomerix, Giteliscope, Ossio, and Regentis; receives royalties from Arthrex, DJ Orthopaedics, Encore Medical, and Saunders/Mosby-Elsevier; is a paid speaker/presenter for Carticept and Pacira Pharmaceuticals; has received hospitality payments from DePuy, Genzyme, and Lifenet Health; and receives other financial/material support including compensation for travel and lodging or food/beverages from Athletico, JRF Ortho, Smith & Nephew, and Tornier. A.E.W. receives royalties from Smith & Nephew; receives educational support from Arthrex; is a consultant for Smith & Nephew; and receives hospitality payments from Smith & Nephew, Arthrex, and Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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