A three-dimensional (3D) printed simulator as a feasible assessment tool for evaluating hip arthroscopy skills.

Abstract

The aims of this study were (1) to develop a three-dimensional (3D) printed simulator that facilitates the simulation of surgical skills for portal placement, intra-articular identification of anatomical structures and arthroscope navigation for hip arthroscopy and (2) to concurrently examine the feasibility of using this simulator as an assessment tool to evaluate trainees' surgical competencies. A simulator was developed using a combination of medical imaging, computer-aided design, and 3D printing. A cross-sectional study was conducted with 29 participants divided into 3 subgroups (novice, intermediate and experienced). All participants performed related skills on the simulator, and their performance was evaluated using different assessment parameters. The participants' qualitative feedback regarding the simulator was also collected. The data collated from each group of participants were subsequently compared. Significant differences were observed between the three subgroups of participants with regard to the total checklist score (F_2,26 = 11.3), total Arthroscopic Surgical Skill Evaluation score (F_2,26 = 92.1), overall final global rating scale score (F_2,26 = 49), number of times the participants used fluoroscopy (F_2,26 = 7.4), and task completion times (F_2,26 = 23.5). The participants' performance in the simulated operation was correlated with their prior clinical experience. There was mainly positive feedback with regard to the fidelity and utility of the simulator in relation to the surgeons' prior clinical experience. This study demonstrated that a reliable hip arthroscopic simulator can be developed for use by orthopedic surgeons to evaluate their hip arthroscopic skills before performing actual surgical operations. Level III.