Abstract
Introduction
Surgical simulation and ‘virtual’ surgical tools are becoming recognised as essential aids for speciality training in Trauma & Orthopaedics, as evidenced by the BOA T&O Simulation Curriculum 20131,2. The current generation of hip arthroplasty simulators, including cadaveric workshops, offers the trainee limited exposure to reproducible real life bony pathology. We developed and implemented a novel training course using pathological dry bone models generated from real patient cases to support senior orthopaedic trainees and new consultants in developing knowledge and hands on skills in complex total hip arthroplasty.
Patient/Materials & Methods
A two-day programme for 20 delegates was held at a specialist centre for hip arthroplasty. Three complex femoral and three complex acetabular cases were identified from patients seen at our centre. 3D models were printed from CT scans and dry bone models produced (using a mold-casting process), enabling each delegate to have a copy of each case at a cost of around £30 per case per delegate (Figure 1). The faculty was led by 4 senior Consultant revision hip surgeons. A computerised digitising arm was used to measure cup positioning and femoral stem version giving candidates immediate objective feedback (Figure 2). Candidate experience and satisfaction with the course and models was evaluated with a standardised post-course questionnaire.
Results
91% of respondents rated overall course satisfaction good or very good with 100% stating learning objectives were met or exceeded. 100% of delegates rated the bone model workshop cases as good or very good for the acetabular course, and 88% for the femoral course.
Discussion
This course has been shown to enhance learning of surgical techniques and skills in complex hip surgery.
Conclusion
We have developed a novel, effective and low cost training simulation method using pathological dry bone models for complex and revision hip arthroplasty which could be developed for other anatomical areas.