Learning curves in arthroscopic surgery: A scoping review of knee, shoulder, and hip procedures

Background and aims: Arthroscopic surgery is a technically demanding modality with outcomes closely linked to surgeon experience. Learning curves vary across joints due to differences in anatomy, access, and procedural complexity. Understanding these learning trajectories is essential to optimize training, patient safety, and early independent practice. The purpose of the study is to systematically map existing evidence on learning curves in knee, shoulder, and hip arthroscopy, with emphasis on operative efficiency, clinical outcomes, complication rates, and the influence of surgeon experience and practice environment. Materials and Methods: This study was conducted as a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. PubMed/MEDLINE and Embase were searched for peer-reviewed clinical studies published over the past 25 years evaluating learning curve metrics. Surgeons were categorized as novice (<30 cases) or experienced (≥30 cases). Results: Knee arthroscopy demonstrated a relatively short learning curve, with early gains in technical efficiency. Shoulder arthroscopy showed progressive reductions in operative time and retear rates, with meaningful improvements observed beyond 50–100 cases. Hip arthroscopy exhibited the steepest learning curve, with significant reductions in operative/traction times and complication rates occurring after approximately 70–110 cases. Practice in tertiary care settings was consistently associated with improved efficiency and safety profiles. Conclusion: Learning curves in arthroscopy are joint-specific and most pronounced in hip and complex shoulder procedures. Structured training, mentorship, and early practice within high-volume tertiary care centers play a critical role in flattening the learning curve.