Paper #2 - ISHA Annual Scientific Meeting 2016

Testing the Validity and Utility of a Virtual Reality Hip Arthroscopy Simulator

Vikas Khanduja, MA (Cantab), MSc, FRCS, FRCS (Tr & Orth), Cambridge, Cambridgeshire UNITED KINGDOM
John E Lawrence, MRCS, Cambridge UNITED KINGDOM
Emmanuel Audenaert, MD, PhD, Ghent BELGIUM

Addenbrookes - Cambridge University Hospital, Cambridge, Cambridgeshire, UNITED KINGDOM

FDA Status Not Applicable

Summary: Virtual Reality Hip Arthroscopy Simulator

Abstract:
Purpose
Arthroscopic hip surgery is a technically demanding surgical technique with a steep learning curve. Virtual reality (VR) simulation may have a role in early training in the technique by familiarising trainees with the basic concepts required for this type of surgery. We aimed to test the construct validity of the hip diagnostics module of the Simbionix Arthro Mentor™ simulator by comparing novice performance to an expert benchmark over two modules of increasing difficulty.

Methods
Ten novice surgeons and nine experts performed a simulated arthroscopic examination of a healthy hip joint with a focus on visualising specific targets within the capsule. This was followed by a module testing basic probe examination of the joint. Each surgeon’s performance was evaluated using a set of metrics defined by the simulator, including duration, number of soft tissue & bone collisions, and distance travelled by instruments.

Results
On the visualisation task, the expert group outperformed the novice group on time taken (P=0.0003), number collisions with soft tissue (P=0.001), number of collisions with bone (P=0.002) and distance travelled by the arthroscope (P=0.02). On the probe examination, the two groups differed only in the time taken to complete the task (P=0.025) with no significant difference in other metrics.

Conclusions
Increased experience in hip arthroscopy was reflected by better performance on the simulator, supporting its construct validity. However, novice surgeons exhibited skill progression during the session, with their performance in the second module coming closer to that of the experts.