Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 18:16:249-256.
doi: 10.1016/j.jcot.2021.02.014. eCollection 2021 May.

Active vs passive haptic feedback technology in virtual reality arthroscopy simulation: Which is most realistic?

Kalpesh R Vaghela  1 , Amaury Trockels  2 , Marco Carobene  3
Affiliations

Active vs passive haptic feedback technology in virtual reality arthroscopy simulation: Which is most realistic?

Kalpesh R Vaghela et al. J Clin Orthop Trauma. .

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Jul 30;20:101539. doi: 10.1016/j.jcot.2021.101539. eCollection 2021 Sep. J Clin Orthop Trauma. 2021. PMID: 34405084 Free PMC article.

Abstract

Background: Virtual Reality (VR) simulators are playing an increasingly prominent role in orthopaedic training and education. Face-validity - the degree to which reality is accurately represented - underpins the value of a VR simulator as a learning tool for trainees. Despite the importance of tactile feedback in arthroscopy, there is a paucity for evidence regarding the role of haptics in VR arthroscopy simulator realism.

Purpose: To assess the difference in face validity between two high fidelity VR simulators employing passive and active haptic feedback technology respectively.

Method: 38 participants were recruited and divided into intermediate and expert groups based on orthopaedic training grade. Each participant completed a 12-point diagnostic knee arthroscopy VR module using the active haptic Simbionix ARTHRO Mentor and passive haptic VirtaMed ArthroS simulators. Subsequently, each participant completed a validated simulator face validity questionnaire.

Results: The ARTHRO Mentor active haptic system failed to achieve face validity with mean scores for external appearance (6.61), intra-articular appearance (4.78) and instrumentation (4.36) falling below the acceptable threshold (≥7.0). The ArthroS passive haptic simulator demonstrated satisfactory scores in all domains: external appearance (8.42), intra-articular appearance (7.65), instrumentation (7.21) and was significantly (p < 0.001) more realistic than ARTHRO Mentor for all metrics. 61% of participants gave scores ≥7.0 for questions pertaining to haptic feedback realism from intra-articular structures such as menisci and ACL/PCL for the ArthroS vs. 12% for ARTHRO Mentor. There was no difference in face-validity perception between intermediate and expert groups for either simulator (p > 0.05).

Conclusion: Current active haptic technology which employs motors to simulate tactile feedback fails to demonstrate sufficient face-validity or match the sophistication of passive haptic systems in high fidelity arthroscopy simulators. Textured rubber phantoms that mirror the anatomy and haptic properties of the knee joint provide a significantly more realistic training experience for both intermediate and expert arthroscopists.

Keywords: Arthroscopy; Simulation; Training; Virtual reality.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
VirtaMed ArthroS™ arthroscopy simulator (https://www.virtamed.com/en/aoa/).
Fig. 2
Fig. 2
3D systems arthro Mentor™ arthroscopy simulator (https://www.3dsystems.com/medical-simulators/simbionix-arthro-mentor).
Fig. 3
Fig. 3
Comparative mean results of the passive and active arthroscopy simulator questionnaire scores. Error bars denote standard deviation. All pairwise comparisons shown below are significantly different (p < 0.001).
Fig. 4
Fig. 4
Comparative mean scores of the active haptic arthroscopy simulator questionnaire for intermediates and experts. Error bars denote standard deviation. None of the pairwise comparisons below were significantly different (p > 0.05).
Fig. 5
Fig. 5
Comparative mean scores of the passive haptic arthroscopy simulator questionnaire for intermediates and experts. Error bars denote standard deviation. None of the pairwise comparisons below were significantly different (p > 0.05).
See this image and copyright information in PMC

References

    1. Bota Collaborators, Rashid M.S. An audit of clinical training exposure amongst junior doctors working in Trauma & Orthopaedic Surgery in 101 hospitals in the United Kingdom. BMC Med Educ. 2018;18:1. - PMC - PubMed
    1. Gmc . 2019. The State of Medical Education and Practice in the UK.
    1. Wilson T., Sahu A., Johnson D.S., Turner P.G. The effect of trainee involvement on procedure and list times: a statistical analysis with discussion of current issues affecting orthopaedic training in UK. Surgeon. 2010;8:15–19. - PubMed
    1. Kim S., Bosque J., Meehan J.P., Jamali A., Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of national surveys of ambulatory surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93:994–1000. - PubMed
    1. Irani J.L., Mello M.M., Ashley S.W., Whang E.E., Zinner M.J., Breen E. Surgical residents’ perceptions of the effects of the ACGME duty hour requirements 1 year after implementation. Surgery. 2005;138:246–253. - PubMed

LinkOut - more resources