Resident Involvement is Not Associated with Increased Risk of Postoperative Complications After Arthroscopic Knee Surgery: A Propensity Matched Study.

Abstract Purpose The purpose of this study is to investigate whether resident involvement in knee arthroscopy procedures affects postoperative complications or operative times. Methods The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) registry was queried to identify patients who underwent common knee arthroscopy procedures between 2006 through 2012. Patients with a history of knee arthroplasty, septic arthritis or osteomyelitis of the knee, concomitant open or mini-open procedures, or without information on resident involvement were excluded. A 1:1 propensity score match was performed based on age, sex, obesity, smoking history, and American Society of Anesthesiologist (ASA) classification to match cases with resident involved to non-resident cases. Fisher’s exact test, Pearson’s Chi-square tests, and Wilcoxon rank sum test were utilized to compare patient demographics, comorbidities, and 30-day complications. Wilcoxon rank sum tests were used to compare operative time and length of hospital stay between the two groups, with statistical significance defined as P Results After matching, 2,954 cases (50% resident involvement) were included in the study with no significant differences in demographics or comorbidities between the two cohorts. The overall rate of 30-day complications was 1.1% in the non-resident and resident involved group (P=1.000). There was no significant difference in postoperative surgical (Non-Resident vs Resident Involved: 0.48% vs 0.83%, P=0.2498) or medical (Non-Resident vs Resident Involved: 0.62% vs 0.83%, P=0.5111) complications. However, knee arthroscopy cases that residents were involved with had significantly longer operative times (69.8 min vs 66.8 min, P=0.0002), and length of hospital stay (0.85 days vs 0.21 days, P=0.0332) when compared with cases performed without a resident. Conclusions Resident involvement in knee arthroscopy procedures is not a significant risk for medical or surgical 30-day postoperative complications. Resident participation in knee arthroscopy was associated with statistically significant, but likely clinically insignificant increased operative time as well as length of hospital stay.