Which is more effective? Porcine tendon or 3D- printed flexor tendon? A study of model realism and educational utility in a flexor tendon repair workshop.

Introduction: Animal models in orthopaedic surgical training have raised concerns about ethics and availability, prompting the search for non-animal alternatives. The 3D-printed silicone tendon model has emerged as a potential alternative due to its hygiene and reusability. This study aimed to compare the effectiveness of the two models for flexor tendon repair training. Materials and methods: A survey involved 25 postgraduate trainees with no prior experience in flexor tendon repair. Porcine tendon models and 3D-printed models were used, with participants evaluating accuracy, understanding of pulley systems, joint flexion, tissue feel, and model realism. Repairs were evaluated by experienced surgeons, and participants completed a survey. Results: Both models demonstrated satisfactory accuracy and realistic joint flexion. The porcine model scored higher in anatomical accuracy, while the 3D-printed model excelled in understanding pulley systems. The porcine model provided realistic tissue feel, while the 3D-printed model facilitated anatomy teaching. No significant difference was found in educational utility. The 3D-model was perceived as hygienic and odourless, whereas the porcine model offered better tendon handling. The 3D-model improved visualization of suture placement. Both models were equally accepted and recommended for training. Conclusion: The 3D-printed silicone tendon model is a cost-effective and reproducible alternative to porcine models in flexor tendon repair training. Although the 3D-printed model has limitations in mimicking human tendons, it was equally effective in teaching suturing techniques and improving repair skills. Combining the porcine model and 3D-printed model provides a comprehensive approach to flexor tendon repair training, addressing the limitations of each model and enhancing the educational experience.