The present study validated a novel arthroscopy simulator for hip arthroscopy.
Hip Arthroscopy is technically demanding and associated with a learning curve for safe and proficient practice. Recently, arthroscopic simulators have been developed to anatomically model different joints including the knee, shoulder, and most recently the hip. The purpose of this study is to validate a novel hip arthroscopy simulator.
Twenty-one trainees and one fellowship-trained sports medicine orthopaedic surgeon at an academic institution were recruited to perform a diagnostic hip arthroscopy using the VirtaMed ArthroS hip simulator. Trainee characteristics including level of training, general arthroscopy experience, and hip specific arthroscopy experience were gathered via questionnaire. Performance metrics including composite score, time, camera path length, and cartilage damage were recorded by the simulator for each attempt. Participants were categorized as novice (<25), intermediate (25-75), or advanced (>75) arthroscopists based on the number of arthroscopy procedures performed.
Overall performance on the simulator was significantly higher in those with more arthroscopy experience. Composite performance score in the novice cohort was 114.5 compared to 146.4 and 151.5 in the intermediate and advanced cohort (p = 0.0019), respectively. Novice arthroscopists performed the module in an average time of 321 seconds compared to 202s and 181s in the intermediate and advanced cohort (P< 0.002), respectively. Camera path length required also improved with experience, 202cm in the novice cohort versus 172cm and 147cm in the intermediate and expert cohort, respectively, but was not statistically significant (p = 0.3804). Cartilage damage and safety score did not differ significantly between groups. Simulator composite score and time showed strong correlation with year of training (r = 0.65 and -0.70, respectively).
The ArthroS hip simulator shows good construct validity and performance correlates highly with number of arthroscopic cases reported during training. Certain metrics such as simulated cartilage injury cannot distinguish between different levels of surgical experience.