Design and assessment of a 3D-printed wrist arthroscopy simulator

Abstract

Introduction: Wrist arthroscopy is a technically demanding procedure with a long learning curve, and many trainees report limited exposure during their surgical education. Simulation offers an accessible and ethical alternative to cadaver training. The objective of this study was to create a three-dimensional printed wrist arthroscopy simulator and to evaluate its ability to improve surgical performance.

Methods: A wrist CT scan was segmented to extract the anatomical structures, which were then modelled and printed. The wrist was produced using soft or rigid resin depending on each structure, with replication of the major intercarpal and radiocarpal ligaments. A vertically adjustable support was designed to hold the artificial wrist on standard work surfaces for ergonomic training. An otoscope camera was selected for its video quality and effectiveness. Twenty-two surgeons of varying experience levels (residents, fellows and attending surgeons) completed a training programme composed of an initial assessment on a cadaver wrist, three sessions on the simulator, and a final assessment on the same cadaver wrist. Technical performance, procedure time, involuntary camera removals and perceived workload were assessed. Simulator fidelity and educational value were evaluated via questionnaires.

Results: All participants improved their performance between the initial and final cadaver assessments. Improvements were greatest among residents. Participants completed procedures faster, with fewer errors and reduced perceived workload. The simulator was rated highly for anatomical realism and educational value.

Conclusion: The quality and the low cost of this wrist arthroscopy simulator tend to encourage educational teams to use it in the training of surgeons.

Keywords: 3D printing; arthroscopy; education; simulation; wrist.