Haptic Feedback Can Provide an Objective Assessment of Arthroscopic Skills

• Published in: Clinical orthopaedics and related research 2008-04, Vol.466 (4), p.963-968
• Main Authors: Chami, George, Ward, James W., Phillips, Roger, Sherman, Kevin P.
• Format: Article
• Language: English
• Subjects: Arthroscopes; Arthroscopy; Arthroscopy - standards; Biological and medical sciences; Clinical Competence; Computer-Assisted Instruction; Conservative Orthopedics; Diseases of the osteoarticular system; Endoscopy; Equipment Design; Feedback, Psychological; Humans; Investigative techniques, diagnostic techniques (general aspects); Knee Joint - surgery; Medical sciences; Medicine; Medicine & Public Health; Motor Skills; Original; Original Article; Orthopedics; Quality of Health Care; Signal Processing, Computer-Assisted; Sports Medicine; Surgery; Surgical Orthopedics; Task Performance and Analysis; Time Factors; Torque; User-Computer Interface
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-008-0115-9

The outcome of arthroscopic procedures is related to the surgeon’s skills in arthroscopy. Currently, evaluation of such skills relies on direct observation by a surgeon trainer. This type of assessment, by its nature, is subjective and time-consuming. The aim of our study was to identify whether haptic information generated from arthroscopic tools could distinguish between skilled and less skilled surgeons. A standard arthroscopic probe was fitted with a force/torque sensor. The probe was used by five surgeons with different levels of experience in knee arthroscopy performing 11 different tasks in 10 standard knee arthroscopies. The force/torque data from the hand and tool interface were recorded and synchronized with a video recording of the procedure. The torque magnitude and patterns generated were analyzed and compared. A computerized system was used to analyze the force/torque signature based on general principles for quality of performance using such measures as economy in movement, time efficiency, and consistency in performance. The results showed a considerable correlation between three haptic parameters and the surgeon’s experience, which could be used in an automated objective assessment system for arthroscopic surgery. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.