VirtaMed | ArthroS™ simulator for knee and shoulder arthroscopy training

Orthopedic surgery requires an intensive didactic program, especially for the very specific skills needed to master arthroscopic surgery. On VirtaMed ArthroS™, trainees use original medical devices, which facilitates a transfer of skills to the OR. Training cases include diagnostic and therapeutic arthroscopy in knee, shoulder, hip, and ankle, as well as basic skills training on the ABOS-mandated FAST module.

Dr. Robert T. Burks, M.D., Dept. of orthopedic surgery, University of Utah, USA

The ability of the simulator to show a large number of different pathologies, to identify them and to document them distinguishes the VirtaMed ArthroS™ from training on conventional models, but also from training in the operating room or on cadavers where this high number of variability is not present. This is really what makes the VirtaMed ArthroS™ a unique training tool.

Modules

Fundamentals of arthroscopic surgery

The VirtaMed ArthroS™ FAST module follows the AANA FAST (Fundamentals of Arthroscopic Surgery Training) program. This program has been developed within the ABOS mandate for surgical skills training in collaboration with AANA. It contains a number of motor skill training tasks that guide trainees through the first steps of arthroscopy.

The non-anatomical FAST workstation facilitates structured and ambidextrous training of fundamental arthroscopy skills such as image centering, horizon control, telescoping, triangulation, and using different optics. Integrated courses follow a progressive and ambidextrous training paradigm as suggested by the AANA FAST program.

Arthroscopy: basic skills

Acquiring basic arthroscopic skills requires a commitment to learning and many repetitions of the same interventions. The new basic skill training on the VirtaMed ArthroS™ simulator makes climbing up the learning curve fun. Exercises are great for honing your skills, as illustrated by "catch the stars", where stars are hidden below the meniscus, between ligaments, or bones.

The SimProctor™, a great teaching feature, shows the trainee exactly how to perform a correct diagnostic tour through different portals. The SimProctor™ uses ghost tools and colored hints to speed up learning. Trainees understand the concept of triangulation and can handle instruments without causing damage inside the joint.

Diagnostic arthroscopy

Varying levels of difficulty offer trainees the chance to perform complete diagnostic arthroscopic interventions. For knee arthroscopy training, patient cases include different meniscus lesions, an unhappy triad, chondromalacia, and arthrosis grade I-IV. For shoulder arthroscopy training, patient cases include different lesions in the rotator cuff, SLAP II, Bankart lesion, and impingement syndrome. Both knee and shoulder modules also include the case "Unknown pathology", which will introduce a random patient case for the trainee to recognize and diagnose.

The new teaching feature SimProctor™ takes over some of the teaching and mentoring done by senior medical staff. The SimProctor™ highlights regions such as patella, meniscus, or different ligaments. A feedback report is generated after each virtual procedure, rating surgical skills including safe handling of instruments and unintended collisions with tissue or bones.

Surgical knee and shoulder arthroscopy

Over 20 patients with various lesions in different locations provide training for the first steps in operative arthroscopy using original instruments like an arthroscope, punch, grasper, or shaver. The arthroscopy course curriculum includes different meniscus lesions, synovitial membrane inflammations, subacromial debridement, decompression, and loose body removal.

Again, the SimProctor™ offers helpful support. It shows the trainee with ghost views how to hold instruments, how to the bend knee or shoulder, and where to cut, shave, and/or grasp.

ACL reconstruction

Our latest addition to the ArthroS™ Knee module is the supplementary ACL Reconstruction Module. In this module the surgeon gets to diagnose an ACL tear, remove the injured ligament, and find the optimal locations to drill holes in the femur and tibia bones for the replacement graft.

The accompanying didactic slides teach trainees the basic concepts of ACL reconstruction, while the simulator's outside view and the 3-D training module help the trainee understand how slight changes in the replacement graft's location can affect the joint function.

Platforms

VirtaMed ArthroS™ with knee model

The VirtaMed ArthroS™ platform can come with a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.

The knee, shoulder, hip, and ankle model with magnetic tracking provide realistic tactile sensation.

For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling, camera technique, and familiarize trainees with the concept of 0, 30, and 70-degree optics.

The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.

VirtaMed ArthroS™ with shoulder model

The VirtaMed ArthroS™ platform comes with either a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.

The knee, shoulder, hip, and ankle model come with magnetic tracking that provides realistic tactile sensation. For the shoulder and hip model, lateral decubitus and beach chair positions are also supported.

For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling and camera technique. Trainees are also familiarized with the concept of 0, 30 and 70-degree optics.

The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.

VirtaMed ArthroS™ with hip model

The VirtaMed ArthroS™ platform comes with either a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.

The knee, shoulder, hip, and ankle model come with magnetic tracking that provides realistic tactile sensation. For the hip and shoulder model, lateral decubitus and beach chair positions are also supported.

For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling and camera technique. Trainees are also familiarized with the concept of 0, 30 and 70-degree optics.

The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.

VirtaMed ArthroS™ with ankle model

The VirtaMed ArthroS™ platform can come with a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.

The knee, shoulder, hip, and ankle model with magnetic tracking provide realistic tactile sensation.

The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.

VirtaMed ArthroS™ FAST model

This virtual reality module is based on the Sawbones FAST workstation, which was developed under the guidance of AANA and an ABOS task force. Surgeons can now practice the basic skills needed before they actually go on and perform complex knee or shoulder arthroscopies.

The basic motor skill training tasks on the FAST workstation guide the trainee through the first steps of arthroscopy. Trainees learn which portal to choose and how to perform a correct access. Basic camera navigation tasks include steadiness and image centering, horizon control, periscoping and telescoping. They also learn to use different camera optics and the use of both hands for camera handling, thus allowing for the training of the dominant and non-dominant hand. Trainees get to know how to detect and center an object, probe and measure static objects, and develop triangulation skills.

The workstation and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.

Read about the VirtaMed ArthroS™ Ankle release

Read about the VirtaMed ArthroS™ Hip release