Comparing porcine models and sawbones as a training tool for complex arthroscopic knee surgery

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction and meniscal repair are two commonly performed arthroscopic soft tissue surgeries. It can be challenging for training surgeons to become proficient in these techniques. The aim of our study is to investigate the viability of porcine stifles as training models for ACL reconstruction and meniscal repair. Method: A training session was held with various participants comparing the use of porcine stifles vs. sawbone replicas. Tendon harvesting, joint arthroscopy, meniscal repair and ACL reconstruction were performed on both groups of joints. The two training methods were compared by the completion of a questionnaire by four participants. Results: Porcine stifles were found to be a suitable alternative to human knee joints. Tactile sensation of performing these procedures with porcine stifles more closely resembled that of a human knee. Visualisation of the joint and its structures was considerably easier in the saw bone model, but the porcine stifle better resembled real life scenarios. The medial joint compartment was notably more difficult to visualise and access relative to the lateral compartment, increasing procedure time when repairing the medial meniscus. Conclusion:Porcine stifles provide a suitable model for education and surgical training for ACL reconstruction and meniscal repair for trainee surgeons. They are easy to procure, cost-effective, and better replicate the complexities of these procedures in human knees compared to sawbones. We believe that practically this provides an ideal platform for simulation scenarios which are similar to humans and fulfils the ethical mandates of beneficence and non-maleficence.