Hip Arthroscopy Simulator Training With Immersive Virtual Reality Has Similar Effectiveness to Nonimmersive Virtual Reality

Omar F Rahman; Kyle N Kunze; Kaisen Yao; Susan Y Kwiecien; Anil S Ranawat; Michael B Banffy; Bryan T Kelly; Gregory J Galano

doi:10.1016/j.arthro.2024.02.042

Hip Arthroscopy Simulator Training With Immersive Virtual Reality Has Similar Effectiveness to Nonimmersive Virtual Reality

Arthroscopy. 2024 Mar 19:S0749-8063(24)00207-X. doi: 10.1016/j.arthro.2024.02.042. Online ahead of print.

Authors

Omar F Rahman¹, Kyle N Kunze², Kaisen Yao³, Susan Y Kwiecien³, Anil S Ranawat², Michael B Banffy⁴, Bryan T Kelly², Gregory J Galano³

Affiliations

¹ Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, U.S.A.; Department of Orthopaedics, Lenox Hill Hospital-Northwell Health, New York, New York, U.S.A.. Electronic address: omarrahman1@gmail.com.
² Department of Orthopaedics, Hospital for Special Surgery, New York, New York, U.S.A.
³ Department of Orthopaedics, Lenox Hill Hospital-Northwell Health, New York, New York, U.S.A.
⁴ Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, U.S.A.

PMID: 38513878
DOI: 10.1016/j.arthro.2024.02.042

Abstract

Purpose: To (1) compare the efficacy of immersive virtual reality (iVR) to nonimmersive virtual reality (non-iVR) training in hip arthroscopy on procedural and knowledge-based skills acquisition and (2) evaluate the relative cost of each platform.

Methods: Fourteen orthopaedic surgery residents were randomized to simulation training utilizing an iVR Hip Arthroscopy Simulator (n = 7; PrecisionOS) or non-iVR simulator (n = 7; ArthroS Hip VR; VirtaMed). After training, performance was assessed on a cadaver by 4 expert hip arthroscopists through arthroscopic video review of a diagnostic hip arthroscopy. Performance was assessed using the Objective Structured Assessment of Technical Skills (OSATS) and Arthroscopic Surgery Skill Evaluation Tool (ASSET) scores. A cost analysis was performed using the transfer effectiveness ratio (TER) and a direct cost comparison of iVR to non-iVR.

Results: Demographic characteristics did not differ between treatment arms or by training level, hip arthroscopy experience, or prior simulator use. No significant differences were observed in OSATS and ASSET scores between iVR and non-iVR cohorts (OSATS: iVR 19.6 ± 4.4, non-iVR 21.0 ± 4.1, P = .55; ASSET: iVR 23.7 ± 4.5, non-iVR 25.8 ± 4.8, P = .43). The absolute TER was 0.06 and there was a 132-fold cost difference of iVR to non-iVR.

Conclusions: Hip arthroscopy simulator training with iVR had similar performance results to non-iVR for technical skill and procedural knowledge acquisition after expert arthroscopic video assessment. The iVR platform had similar effectiveness in transfer of skill compared to non-iVR with a 132 times cost differential. CLINICAL RELEVANCE: Due to the accessibility, effectiveness, and relative affordability, iVR training may be beneficial in the future of safe arthroscopic hip training.