Fully Immersive Virtual Reality for Total Hip Arthroplasty

• DOI: 10.2106/jbjs.19.00629
• Publication Date: 2020-01-13T10:49:06Z
• Authors: Kartik Logishetty; Wade T. Gofton; Branavan Rudran; Paul E. Beaulé; Justin P. Cobb
• Keywords: Learning curve

Background: Fully immersive virtual reality (VR) uses headsets to situate a surgeon in operating room perform open surgical procedures. The aims of this study were determine (1) if VR curriculum for training residents anterior approach total hip replacement (AA-THR) was feasible, (2) enabled residents’ performance be measured objectively, and (3) cognitive motor skills that learned with use transferred the physical world. Methods: 32 orthopaedic (surgical postgraduate years [PGY]-1 through 4) no prior experience AA-THR during 5 consecutive assessment sessions. Outcome measures related procedural sequence, efficiency movement, duration surgery, visuospatial precision acetabular component positioning femoral neck osteotomy, compared 4 expert surgeons establish competency-based criteria. Pretraining post-training assessments on dry bone models used assess transfer from Results: Residents progressively developed learning curve repeated practice, plateauing, average, after sessions (4.1 ± 0.6 hours); they reached levels 9 10 metrics (except osteotomy angle). Procedural errors reduced by 79%, assistive prompts 70%, 28%. Dominant nondominant hand movements 35% 36%, respectively, head movement 44%. Femoral performed more accurately, implant orientation improved assessments. In world assessments, experts accurate than simulation, but matched simulation all except angle. who best most world, while 2 unable achieve competence despite sustained practice. Conclusions: For novice skills, fully technology can objectively measure progress acquisition as accuracy. Skills environment are environment.