Training models for meniscal repairs and small joint arthroscopy

Kovac, Nikola; Grainger, Nicholas; Hurworth, Mark

doi:10.1111/ans.13063

Cited by 5 publications

(10 citation statements)

References 6 publications

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“…It is especially challenging to achieve proficiency in arthroscopic surgery without hands-on repetition [13], and although computer simulators have been available for several years, fluid management, dynamic resistance, and haptic feedback are valuable simulation features afforded to the trainee learning on flesh-and-bone specimens. Training with human cadaveric models is expensive, and porcine knees, with anatomy similar to the human knee, are inexpensive and readily available [10,11,16,21]. Although arthroscopic training using porcine knees is not a novel concept, studies have not shown that the porcine knee is similar enough to the human cadaveric knee for arthroscopic skills assessment [3,10,21].…”

Section: Discussionmentioning

confidence: 99%

“…Training with human cadaveric models is expensive, and porcine knees, with anatomy similar to the human knee, are inexpensive and readily available [10,11,16,21]. Although arthroscopic training using porcine knees is not a novel concept, studies have not shown that the porcine knee is similar enough to the human cadaveric knee for arthroscopic skills assessment [3,10,21]. This study found that the porcine knee model demonstrated high face validity, because participants attained similar scores on both the human cadaveric and porcine specimens and high reliability with more experienced surgeons achieving higher scores using the porcine model.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, the porcine (pig) knee is known to have similar anatomy to the human knee, and specimens are readily available and easily acquired in most communities [10,11,21]. Porcine knees can be obtained for a cost of less than USD 30 per specimen, and the associated costs of storage and disposal are also lower than those associated with human specimens.…”

Section: Introductionmentioning

confidence: 99%

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A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

Martin

Gillis

Leiter

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Previously validated knee arthroscopy evaluation tools have used human cadaveric knees. This is unsustainable because of the cost and scarcity of these specimens. Porcine (pig) knees are anatomically similar, affordable, and easily obtainable; however, whether porcine knees represent a suitable alternative to human specimens has not been evaluated. Questions/purposes The purpose of this study was to determine whether porcine knees are similar to human cadaveric knees for the assessment of knee arthroscopy skills by evaluating (1) the validity of the porcine model (whether trainees of the same level of ability scored similarly when using the two models) and (2) the reliability of the porcine model (whether surgeons with experience achieved higher scores than surgeons with less experience in the porcine model). Methods Eleven orthopaedic surgery residents (five junior residents and six senior residents), one orthopaedic sports medicine fellow, and three attending orthopaedic surgeons were enrolled. Participants were provided instructions for a proper arthroscopic examination of the knee and asked to identify, and then probe, the listed anatomic structures on both the human and porcine knee specimens. Each participant was asked to demonstrate the following skills: joint manipulation, instrument control and triangulation, fluid management, maintenance of field of view, economy of movement, and efficiency. The Objective Assessment of Arthroscopic Skills (OAAS) and checklist for diagnostic arthroscopy of the knee were used for skills assessment by one observer. Internal consistency, a measure of how well the assessment tool measures the skills being studied, was determined by Cronbach's a and group differences investigated by paired t-test and Wilcoxon signed-rank tests where appropriate. Based on a sample size calculation, a total of 37 subjects would be required for the full-scale research study to achieve a power of 0.80, with a set at 0.05, to detect a difference in OAAS score of 4.73 (25%). This value is outside of the 95% confidence intervals for the human knee. Results We found the porcine model to have a high level of face validity. There was no difference with the numbers available in total OAAS scores (mean ± SD; 95% confidence interval [CI]) within subjects between the human (18.93 ± 7.54; 14.76-23.11) and porcine (17.87 ± 6.36; 14.34-21.39) knees (p = 0.433). There was also no The institution of one or more of the authors (RKM, JL, PM) has received, during the study period, funding from the OMeGA Medical Grants Association. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author from the instituti...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

Martin

Gillis

Leiter

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…T he ideal training to improve the arthroscopic skills of trained surgeons and specialist surgeons is on human cadaver parts. 1 However, there are several difficulties in obtaining human anatomical pieces, such as their high cost (which can reach $500.00 for each piece), storage requirements, and ethical issues. [2][3][4] Alternatives to the use of human cadavers are training with artificial models, 3-dimensional simulators, and animal anatomical models, such as porcine and bovine knee.…”

mentioning

confidence: 99%

“…7 Several studies have already shown that some anatomical animal models are very close to humans and therefore apply well to the training of open and arthroscopic surgical skills. 1,9,10 The bovine model has already been used in several studies and shown itself to be an adequate animal model for arthroscopic training, mainly for arthroscopic triangulation training. 1,6,11 In this article, we describe, step by step, how to set up an arthroscopy laboratory with an anatomical animal model.…”

mentioning

confidence: 99%

How to Create an Arthroscopy Training Laboratory Using a Bovine Knee Model

Faria

Pavão

Sousa

et al. 2021

Arthroscopy Techniques

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Orthopaedic surgeries by video arthroscopy have become increasingly popular, as they allow joint treatment through small incisions and minimal tissue damage. However, their execution requires specific skills from the surgeon, different from open surgery, which can only be achieved through practical training. These skills would be ideally performed on human cadaveric anatomical pieces which, however, can be difficult to access for different reasons. Animal anatomical models for surgical skills training have been used for years in medicine, and we observed that the bovine knee has anatomical characteristics quite similar to that of the human knee. In this study, we explain, step by step, the installation and creation of an arthroscopy laboratory with a bovine model, in an effort to contribute to several training centers in arthroscopic surgery around the world, assisting and guiding such centers to install arthroscopy laboratories and facilitating the improvement of more surgeons.

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Validation of Two Novel and Complementary Training Platforms for Small Joint Arthroscopy

Mizera

Wilson²,

Seref‐Ferlengez³

et al. 2024

The Journal of Hand Surgery

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Training models for meniscal repairs and small joint arthroscopy

Abstract: Porcine stifles are cost effective, accessible, allow for meniscal repair and are suitable for arthroscopic access and view. Our view is that they are an ideal training model for arthroscopic meniscal repair, small joint arthroscopy and anterior cruciate ligament reconstruction.

Cited by 5 publications

References 6 publications

A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

How to Create an Arthroscopy Training Laboratory Using a Bovine Knee Model

Validation of Two Novel and Complementary Training Platforms for Small Joint Arthroscopy

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