The role of virtual reality in knee arthroscopic simulation: a systematic review

• Published in: Musculoskeletal surgery 2023-03, Vol.107 (1), p.85-95
• Main Authors: Capitani, Paolo, Zampogna, Biagio, Monaco, Edoardo, Frizziero, Antonio, Moretti, Lorenzo, Losco, Michele, Papalia, Rocco
• Format: Article
• Language: English
• Subjects: Analysis; Arthroscopy - education; Clinical Competence; Computer Simulation; Education; Humans; Internship and Residency; Medical students; Medicine; Medicine & Public Health; Methods; Original Article; Orthopedics; Surgical Orthopedics; Systematic review; Training; Virtual Reality
• ISSN: 2035-5106; 2035-5114
• DOI: 10.1007/s12306-021-00732-9

Purpose Surgical training is crucial for orthopedics residents during their educational careers. Residents who follow classic training courses are less skilled than those trained with simulators. Virtual simulators are reported to be global learning tools for knee arthroscopy. The primary purpose of our study is to evaluate the current state of use of arthroscopic knee simulators and their actual effectiveness in transfer the skills learned in training to the operating theatre. The secondary purpose is to evaluate if the virtual simulators are better than the others in improve arthroscopic skills. Methods Studies involving knee arthroscopy training with virtual reality simulators were included: a search of the literature from 2009 to September 2019 was performed on MEDLINE(PubMed) using PRISMA guidelines. Exclusion criteria were systematic review articles, aims and topics not related to the purpose of the study, single case and technical reports, biomechanical analysis, articles not in the English language, and editorial commentaries. Results The literature review selected, nine studies and they included results on 93 residents, three expert surgeons and 189 medical students. All studies report improved arthroscopic skills after training with a simulator. Only four studies evaluated the transfer of arthroscopic skills of knee simulators to the operating theatre. Conclusions Benchtop and Virtual Reality simulators are excellent tools for accelerating and improving arthroscopic training and skills acquisition. The second ones, high-cost, and fidelity simulators, seem to be the best of the two. A greater diffusion of Virtual Reality in universities is to be considered to improve residents' training and patients’ clinical outcomes.