Virtual reality-based simulation improves rotator cuff repair skill: A randomized transfer validity study - 27/11/24

Doi : 10.1016/j.otsr.2024.104053

Nicolas Vallée ^a,^b,⁎ , Alexandre Tronchot ^a,^b, Tiphaine Casy ^a, Hervé Thomazeau ^a,^b, Pierre Jannin ^a, Julien Maximen ^b, Arnaud Huaulme ^a
^a Univ. Rennes, Inserm, LTSI – UMR 1099, F-35000 Rennes, France
^b Orthopaedics and Trauma Department, Rennes University Hospital, 2 rue Henri Le Guilloux, 35000, Rennes, France

^⁎Corresponding author at: Univ. Rennes, CHU Rennes, Inserm, LTSI, Equipe MediCIS- UMR 1099, F-35000, Rennes, France.Univ. RennesCHU RennesInsermLTSIEquipe MediCIS- UMR 1099RennesF-35000France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 27 November 2024

Abstract

Background

Although virtual reality (VR) simulators have demonstrated their efficiency for basic technical skill training of healthcare professionals, validation for more complex and sequential procedures, especially in arthroscopic surgery, is still warranted. We hypothesized that the VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions.

Hypothesis

VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions.

Study design

This study is prospective, multicentric and randomized.

Methods

Thirty orthopedic surgery residents were enrolled in the study and randomized in two groups: VR training (VR+) and no VR training (VR−). Only the VR+ group underwent a monthly VR-based training program for rotator cuff repair. The 1-h VR training sessions were standardized and supervised by the same instructor. After six months, all participants performed a double-row arthroscopic rotator cuff repair procedure on a benchtop shoulder model providing realistic visual and haptic conditions with implants. Two independent surgeons with expertise in shoulder repair and blinded to the randomization rated the participants' performance using the Arthroscopic Surgical Skill Evaluation Tool (ASSET).

Results

Demographic characteristics and surgical experience were comparable between the two groups. The ASSET global rating score was higher in the VR+ group than in the VR- group (34.4 ± 3.1 and 30.5 ± 5.7, respectively; p = 0.046) and the VR+ group performed the procedure faster than the VR- group (27.3 ± 3.6 vs. 31.7 ± 0.4 min, respectively; p = 0.003).

Discussion

This study demonstrated that a monthly VR-based program for 6 months was better than standard peer training alone for mastering a complex and sequential rotator cuff repair when using the validated ASSET Score. Overall, nonspecific arthroscopic skills were also higher in the VR+ group.