Decreased Case Volume for Orthopaedic Sports Medicine Fellows During the Early Stages of the COVID-19 Pandemic

Arthrosc Sports Med Rehabil. 2022 May 19. doi: 10.1016/j.asmr.2022.04.019. Online ahead of print.

Abstract

Purpose: The purpose of the current study was to compare the surgical case volume for orthopaedic sports medicine fellows in the most recent classes to one another and in years preceding the pandemic.

Methods: ACGME case log reports of key procedures for orthopaedic sports medicine fellows during academic years 2018-2019, 2019-2020, and 2020-2021 were extracted. Comparisons between these years in adult, pediatric and total case volumes were performed using two-sample T-test to detect significant changes in the average number of key procedures completed between consecutive years.

Results: There was a significant decrease in the total number of cases completed by fellows during the 2020 academic year (p = 0.043) compared to 2019, immediately followed by a significant increase in case volume in 2021 (p < 0.001) (2019, 339 +/- 123; 2020, 316.2 +/- 108; 2021, 356.5 +/- 117). There was a significant increase in adult case volume from 2020 to 2021 (2020, 295.7 +/- 106; 2021, 332.9 +/- 117; p < 0.001), while no trends were noted in pediatric case volume. Between the pre-pandemic year of 2019 and the first year of the pandemic, significant decreases were noted in case volume for several procedures, including multiligamentous knee injuries, knee instability and pediatric hip arthroscopy. From the first to the second years of the pandemic (2019-2020 to 2020-2021), significant increases were observed in case volume for rotator cuff, acromioclavicular instability, elbow instability, knee cartilage, and meniscal surgeries.

Conclusions: Orthopaedic sports medicine fellows experienced significant decreases in volume for several key case categories between the year preceding the COVID-19 pandemic and the first academic year during the pandemic. There were subsequent increases in cases between the first year of the pandemic and the second year, which may be associated with resuming elective surgical cases.

Keywords: ACGME; COVID-19; Sports medicine fellowship; arthroscopy; case volume.