The benefits of intraoperative virtual reality distraction in anterior cruciate ligament reconstruction (ACLR) under spinal anaesthesia.

Purpose: Patient anxiety in anterior cruciate ligament reconstruction (ACLR) is a preventable potential risk factor for poor patient satisfaction and surgical outcomes. This study aimed to assess the impact of virtual reality (VR) on the anxiety of patients undergoing ACLR under spinal anaesthesia (SA). The primary outcome was the perioperative patient anxiety level as assessed by the State-Trait Anxiety Inventory (STAI-Y1) score. Methods: A prospective randomised controlled study, of a single-centre series of patients undergoing ACLR + Lemaire lateral extra-articular tenodesis (LET) under SA, was conducted. Patients were randomised into two groups: Group 1 was a control group, where standard ACLR was performed, and Group 2 had ACLR performed with VR headset used. Pre- and postoperative VAS pain, comfort and anxiety were recorded. Additionally, pre-and postoperative patient anxiety was recorded by the State-Trait Anxiety Inventory (STAI) Score. STAI-Y1 score form was used, which assesses the state (current) level of anxiety. Intraoperative adverse events were recorded including sedation requirements and rescue analgesia and patient postoperative satisfaction was recorded. Results: A total of 60 patients underwent ACLR + LET under SA. Patients were randomised into 2 groups: Group 1 ( Conclusion: Virtual reality-augmented anterior cruciate ligament reconstruction results in significantly fewer intraoperative adverse events, significantly less intraoperative and less immediate postoperative patient's anxiety, and higher overall patient satisfaction when assessed by the anaesthetic team. Level of Evidence: Level I, randomised controlled trial.