Use of bovine carpal joints as a training model for cruciate ligament repair

Calvert, Nicholas; Grainger, Nicholas; Hurworth, Mark

doi:10.1111/ans.12308

Cited by 6 publications

(8 citation statements)

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“…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 addition, cadaveric wet laboratories are often limited to diagnostic arthroscopy to maximize use of specimens for multiple trainees. Computer simulators provide objective feedback and minimize costs associated with repetition, but again their value is limited to basic arthroscopic skills and capital costs are substantial [3,20]. Additionally, trainees using computer simulators forego the haptic feedback that real tissue provides [1], and essential skills such as portal placement and access, managing fluid flow, and the ability to accommodate various techniques and instruments are not incorporated into current simulator models.…”

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: Introductionmentioning

confidence: 99%

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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“…noted that the porcine stifles had a wider and smaller medial meniscus when compared with the human meniscus, whereas the lateral meniscus had a fair resemblance to the human meniscus . In addition to the use of the porcine stifle, there have been publications recognizing the practicality of animal models such ovine and bovine stifles as possible modules for arthroscopic training. Another alternative worth considering is the virtual reality arthroscopic simulators that are currently available in several training institutions across the United States …”

Section: Introductionmentioning

confidence: 99%

Training models for meniscal repairs and small joint arthroscopy

Kovac

Grainger

Hurworth

2015

ANZ Journal of Surgery

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“…[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. [4][5][6][7] Simulators and artificial models have the advantage of easy repetition of training, 8,9 but they do not replicate the exact reality of the procedure, such as contact with the texture and resistance offered by human and animal tissue, for example. 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.…”

mentioning

confidence: 99%

“…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.…”

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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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Use of bovine carpal joints as a training model for cruciate ligament repair

Abstract: The use of bovine carpal joints is a cost-effective, safe and easily reproducible model for education on basic anterior cruciate ligament repair skills and technique prior to patient contact.

Cited by 6 publications

References 10 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

Training models for meniscal repairs and small joint arthroscopy

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

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