Arthroscopic anterior cruciate ligament reconstruction learning curve: Analysis of operating time and clinical outcomes

Abstract

Abstract Background: Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACLR) is complex and requires learning and practice. Achieving an appropriate level of competency with this surgery is important for patient safety and satisfactory surgical outcomes. There is limited literature about the learning curve in ACLR in Africa. Objectives: This study aimed to demonstrate the learning curve associated with ACLR. Materials and Methods: This retrospective study on arthroscopic ACLR was conducted between January 2020 and June 2023 with a minimum of 12 months follow-up. The primary outcome measure was operation time, whereas the secondary outcome measures were functional outcome and postoperative complications. Results: One hundred fifty-nine ACLR met the inclusion criteria and were analysed. The mean age of the patients was 31.47 ± 9.50 years. There were 148 (93.1%) males and 11 (6.9%) females. The median operation time was 50 min (45–190 min). There was progressively decreasing operation time with increasing number of cases done until after the first 19 cases. The mean operating time for the first 19 cases was 143.89 ± 32.84 min, whereas the mean operating time for the later 140 cases was 53.81 ± 9.72 min (P = 0.000). Conclusions: The operation time for arthroscopic ACLR progressively decreased until after the first 19 cases. There was, however, no significant difference in the clinical outcome between the cases done during the learning curve and those done at proficiency.