A 3D-Printed Home-Based Arthroscopic Simulator Improves Basic Surgical Skills: A Prospective Comparative Multicentre Study

TL;DR

A 3D-printed home-based simulator called Arthrozero helps orthopedic residents improve basic arthroscopic skills as effectively as real arthroscopy training.

Contribution

A low-cost, home-based 3D-printed simulator for arthroscopic skill training is shown to be as effective as real arthroscopy training.

Findings

Both ZERO and ARTHRO groups showed significant improvement in training tasks compared to the CONTROL group.

The ZERO group completed the final Shoulder Challenge significantly faster than the CONTROL group.

No significant difference in performance was found between the ZERO and ARTHRO groups.

Abstract

Objectives: Arthroscopic surgery requires complex visuospatial coordination and psychomotor skills, which are traditionally acquired through mentorship and cadaveric training. High-fidelity simulators are effective but often costly and inaccessible. This study evaluates the technical effectiveness of a novel home-based 3D-printed arthroscopic simulator (“Arthrozero”) for improving basic arthroscopic skills among orthopedic residents. Methods: Thirty-three orthopedic residents (25–36 years) from two Italian university centers were randomized into three groups: ZERO (Arthrozero training), ARTHRO (real arthroscope training), and CONTROL (theoretical session). Training was performed on a FAST-like workstation through four progressively complex tasks. Performance metrics included task completion time, number of looks down, and skill progression during a final Shoulder Challenge (SHO-CHA) assessment. A web-based Likert questionnaire evaluated participant satisfaction and perceived educational value. Results: Both ZERO and ARTHRO groups demonstrated significant improvement across training sessions (p < 0.05) for all tasks, while the CONTROL group showed minimal gains. In the SHO-CHA assessment, mean completion times were 394.1 ± 140.7 s (ZERO), 456.1 ± 123.2 s (ARTHRO), and 745.5 ± 190.7 s (CONTROL) (p < 0.01). No significant difference was observed between ZERO and ARTHRO groups (p = 0.276). Conclusions: The home-based Arthrozero simulator demonstrated improvements in basic arthroscopic skill performance, suggesting that it may represent an accessible training tool to support early arthroscopic skill acquisition alongside traditional training methods.

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