Force measurement metrics for simulated elbow arthroscopy training.

Area of Science:

• Orthopedic Surgery
• Surgical Simulation
• Biomechanics

Background:

• Elbow arthroscopy presents significant training challenges.
• Objective metrics are crucial for enhancing the safety and effectiveness of surgical training.
• Quantifying tissue manipulation forces provides a measure of safe practice.

Purpose of the Study:

• To quantify the force magnitude and direction used by experts during arthroscopic elbow navigation in cadavers.
• To evaluate the applicability of these force metrics in elbow arthroscopy training.

Main Methods:

• Two cadaveric elbows were analyzed using a 3D Force Measurement Table (FMT).
• Five experts performed standardized arthroscopic navigation across posterior, posterolateral, and anterior compartments.
• Recorded data included total absolute force (Fabs) and force direction angles (α and β).

Main Results:

• Median absolute forces ranged from 24 N (posterior) to 29 N (anterior).
• Median force direction angles (α) varied by compartment, ranging from -29° to 4°.
• Median force direction angles (β) were consistently negative, ranging from -71° to -76°.

Conclusions:

• Collected expert data provides objective force magnitude and direction metrics for elbow arthroscopy.
• A proposed maximum allowable force of 30 N and compartment-specific force direction ranges can guide training.
• These metrics offer objective feedback for improving arthroscopic skills training.