Immersive virtual reality simulation training enhances technical skill acquisition and procedural accuracy in cadaveric total knee arthroplasty.

introductionAlthough immersive virtual reality (VR) is used for training in various surgical procedures, its efficacy in complex multistep orthopaedic surgeries is less established. The aim of this study was to evaluate the effectiveness of immersive VR simulation training in comparison to the surgical technique guide and video for fixed-bearing total knee replacement (TKA) among junior orthopaedic surgery residents in their first and second years of postgraduate training. MATERIAL AND

methodsTwenty-two orthopaedic surgery residents were blocked randomized into two groups based on year of study: one receiving surgical training for TKA using a surgical technique guide and instructional video (control group, CG), and the other using an immersive VR training module (VR group). Group allocation was determined by drawing envelopes. Following the training, participants performed TKA on cadavers with standardized surgical instruments and implants. Subjective and objective data were collected before, during and after the procedure. Participants were assessed using a procedure-specific checklist, the global ratings scale of the Objective Structured Assessment of Technical Skills (OSATS), and the global summary score of the Procedure-Based Assessment (PBA) for TKA. Operative time was recorded, while confidence and motivation metrics were evaluated through pre- and post-assessment questionnaires.

resultsResidents from a single institution were randomized equally (n = 11) in the VR and CG groups. The VR group achieved significantly higher scores in instrument handling (VR 3.3 ± 0.5 vs. CG 2.5 ± 0.7, p = 0.005) and flow of operation (VR 3.5 ± 0.8 vs. CG 2.7 ± 0.5, p = 0.024) compared to CG group on the OSATS. The VR group performed significantly better than CG group in PBA (VR 4.3 ± 0.6 vs. CG 2.9 ± 0.8, p < 0.001). The VR group achieved significantly higher mean score for correct steps performed than CG group (VR 29.7 ± 2.9, CR 25.8 ± 5.8, p = 0.05). There was no difference in procedure time when comparing the VR group (54.8 ± 14.8 min) with the CG group (55.4 ± 10.9 min; p = 0.93). The VR group would recommend this training method to other trainees and acknowledged that it significantly increased their confidence in performing TKA.

conclusionsAlthough there was no significant difference in TKA completion times between VR and control groups, the VR group demonstrated superior performance in specific skill assessments and executed a higher number of TKA procedural steps correctly. Positive trainee feedback suggests immersive VR training is well-received and has potential for enhancing surgical education in orthopaedics.