# 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.

## Key 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.