Virtual Reality Simulator Improves the Acquisition of Basic Arthroscopy Skills in First-year Orthopedic Surgery Residents

Introduction

Arthroscopy training using a virtual reality (VR) simulator is said to improve the training of orthopedic surgery residents, although it has never been evaluated in a large representative population of first-year residents.

Hypothesis

We hypothesized that first-year residents who train on a VR simulator would improve their basic arthroscopy skills more than residents who use other training methods. The primary aim was to compare various arthroscopy-learning techniques after 6 months of training.

Population and methods

The study population consisted of 107 first-year residents who were tested twice on a VR arthroscopy simulator (December 2017 and June 2018). The residents were divided into three groups: no specific arthroscopy training (A), non-specific and one-off arthroscopy training (B), 6 months of VR arthroscopy simulator training (C). During the testing, they had to perform the Periscoping exercise (orientation of angled scope) and the Catch the Stars Glenohumeral exercise (extraction of loose bodies). The parameters analyzed were time (s), camera alignment relative to horizontal (%), camera path length (cm) and grasper path length (cm).

Results

After 6 months, there was a significant difference between groups during the Periscoping exercise in the time (A: 137.8 s; B: 126.7 s; C: 92.2 s) (p < 0.0001), camera alignment (A: 93%; B: 98%; C: 97%) (p = 0.0028), camera path length (A: 116.9 cm; B: 112.5 cm; C: 67.3 cm) (p < 0.0001) and during the Catch the Stars Glenohumeral exercise in the time (A: 112.2 s; B: 103 s; C: 61.4 s) (p < 0.0001), camera path length (A: 46.3 cm; B: 40.9 cm; C: 32.9 cm) (p < 0.0153) and grasper path length (A: 146.4 cm; B: 142.2 cm; C: 95.8 cm) (p < 0.0001).

Discussion

The residents who participated in the VR arthroscopy simulator training program for 6 months had better results when performing practical exercises and standard arthroscopy tasks than those who did not receive any training or only received only one-off training. Their final performance indicated technical mastery that the other residents had not achieved.

Level of Evidence

II, Prospective, comparative, non-randomized study.