Does Sawbone-Based Arthroscopy Module (SBAM) Can Help Elbow Surgeons?

Luceri, Francesco; Arrigoni, Paolo; Barco, Raúl; Cucchi, Davide; Raj, Nishant; Frassoni, Samuele; Randelli, Pietro

doi:10.1007/s43465-020-00133-3

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…They did determine that the senior surgeons were able to perform the procedure without major errors on their first attempt and that no subsequent improvement was demonstrated on subsequent testing. Luceri et al described how OS were recruited to participate in assessment of simulator practice affected performance on an arthroscopy simulator, the Sawbones Elbow model (Sawbones Europe AB ® ) [ 41 ]. The expert surgeons could complete the task (sequential touching of structures during arthroscopy) in a median of 13 s. On the second attempt the OS improved their task completion time by a median of 1 s. No other metric of assessment was performed.…”

Section: Resultsmentioning

confidence: 99%

“…Continuing professional development is important for provision of quality patient care, hence the emphasis on maintenance of certification by American Board of Orthopaedic Surgery [ 91 ]. In the published work, we identified detailing simulation education in which OS were target learners, two studies described assessment of OS in performing either virtual reality (VR) lateral lumbar access simulation arthroscopy or elbow simulator [ 40 , 41 ]. In these studies, OS were given an educational session and then performance reassessed, but no long term follow up was performed, nor any correlation with clinical practice determined.…”

Section: Discussionmentioning

confidence: 99%

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Simulation training to retool practicing orthopedic surgeons is rare

2023

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Purpose Modern surgical practice is continuously changing as technology develops. New techniques are often implemented after a surgeon has made the transition to independent clinical practice. There is therefore a need to ‘retool’ technical skills. Additionally, practicing surgeons must maintain and develop skills such as leadership, communication, critical thinking, teaching, and mentoring. Our aim was to perform a scoping review to assess the current status of simulation education for practicing Orthopedic Surgeons (OS). Methods A 10 year search of PubMed, ERIC, and Web of Science was performed with a medical librarian. Controlled vocabulary Medical Subject Headings terms and natural language were developed with subject matter experts describing simulation, training and OS. Two trained reviewers evaluated all abstracts for inclusion. Exclusion criteria were articles that did not assess simulation education involving practicing OS. Data were extracted from the included full text articles by two reviewers: details of study design, type of participants, type of simulation and role of OS in the educational event. Results Initial search identified 1824 articles of which 443 were duplicates, and 1381 articles were further screened. Of these, 1155 were excluded, 226 full text articles were assessed for eligibility and 80 included in analysis. Most were published in the last 6 years and from the United States. The majority (99%) described technical skill simulations (arthroscopy 56%, screw placement 23%, ligament reconstruction 19%). OS were rarely the only learners with 91% studies also having residents participate. OS were the targeted learner in 6% studies. OS provided content validity for 15 (19%) and construct validity in 59 (74%) studies. Conclusions Simulation training to educate practicing OS is rare. OS are often used to validate work rather than being the center of an educational endeavor. A refocusing is needed to provide adequate training for practicing surgeons to retool skills as new techniques become available.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Simulation training to retool practicing orthopedic surgeons is rare

2023

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“…Micro-trauma is another clinical scenario that can lead to symptomatic chronic instability, both affecting the medial and the lateral side. Patient with symptomatic minor instabilities complain of chronic elbow pain and limitation in daily activities, which makes demanding and time consuming the process necessary to reach a proper diagnosis and indicated adequate treatment [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Novel Radiographic Indexes for Elbow Stability Assessment: Part B—Preliminary Clinical Study

Luceri

Cucchi

Rosagrata

et al. 2021

IJOO

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Introduction The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population. Methods Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon–coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index. Results 126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3–1.6), the mean ACI was 2.0 ± 0.2 (1.6–3.1) and the mean PCI was 1.3 ± 0.1 (1.0–1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA. Conclusion The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services. Level of evidence Basic Science Study (Case Series). Clinical relevance The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.

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“…Elbow stability is guaranteed by primary and secondary constraints [1][2][3][4]. The ulnohumeral articulation is the most important primary stabilizer of the elbow joint [5][6][7]. Bony stability relies primarily on the high anatomic congruency between the humeral trochlea and the ulnar greater sigmoid notch (GSN).…”

Section: Introductionmentioning

confidence: 99%

Novel Radiographic Indexes for Elbow Stability Assessment: Part A—Cadaveric Validation

Luceri

Cucchi

Rosagrata

et al. 2021

JOIO

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Introduction Elbow bony stability relies primarily on the high anatomic congruency between the humeral trochlea and the ulnar greater sigmoid notch. No practical tools are available to distinguish different morphotypes of the proximal ulna and herewith predict elbow stability. The aim of this study was to assess inter-observer reproducibility, evaluate diagnostic performance and determine responsiveness to change after simulated coronoid process fracture for three novel elbow radiographic indexes. Methods Ten fresh-frozen cadaver specimens of upper limbs from human donors were available for this study. Three primary indexes were defined, as well as two derived angles: Trochlear Depth Index (TDI); Posterior Coverage Index (PCI); Anterior Coverage Index (ACI); radiographic coverage angle (RCA); olecranon–diaphisary angle (ODA). Each index was first measured on standardized lateral radiographs and subsequently by direct measurement after open dissection. Finally, a type II coronoid fracture (Regan and Morrey classification) was created on each specimen and both radiographic and open measurements were repeated. All measurements were conducted by two orthopaedic surgeons and two dedicated musculoskeletal radiologists. Results All three indexes showed good or moderate inter-observer reliability and moderate accuracy and precision when compared to the gold standard (open measurement). A significant change between the radiographic TDI and ACI before and after simulated coronoid fracture was observed [TDI: decrease from 0.45 ± 0.03 to 0.39 ± 0.08 (p = 0.035); ACI: decrease from 1.90 ± 0.17 to 1.58 ± 0.21 (p = 0.001)]. As expected, no significant changes were documented for the PCI. Based on these data, a predictive model was generated, able to identify coronoid fractures with a sensitivity of 80% and a specificity of 100%. Conclusion New, simple and easily reproducible radiological indexes to describe the congruency of the greater sigmoid notch have been proposed. TDI and ACI change significantly after a simulated coronoid fracture, indicating a good responsiveness of these parameters to a pathological condition. Furthermore, combining TDI and ACI in a regression model equation allowed to identify simulated fractures with high sensitivity and specificity. The newly proposed indexes are, therefore, promising tools to improve diagnostic accuracy of coronoid fractures and show potential to enhance perioperative diagnostic also in cases of elbow instability and stiffness. Level of evidence Basic science study. Clinical relevance The newly proposed indexes are promising tools to improve diagnostic accuracy of coronoid fractures as well as to enhance perioperative diagnostic for elbow instability and stiffness.

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Does Sawbone-Based Arthroscopy Module (SBAM) Can Help Elbow Surgeons?

Cited by 6 publications

References 36 publications

Simulation training to retool practicing orthopedic surgeons is rare

Simulation training to retool practicing orthopedic surgeons is rare

Novel Radiographic Indexes for Elbow Stability Assessment: Part B—Preliminary Clinical Study

Novel Radiographic Indexes for Elbow Stability Assessment: Part A—Cadaveric Validation

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