Active vs passive haptic feedback technology in virtual reality arthroscopy simulation: Which is most realistic?

Area of Science:

• Orthopaedic Surgery
• Medical Simulation
• Virtual Reality Technology

Background:

• Virtual Reality (VR) simulators are increasingly vital for orthopaedic training.
• Simulator realism, particularly face validity, is crucial for effective learning.
• Evidence on the role of haptics in VR arthroscopy simulator realism is limited.

Purpose of the Study:

• To compare the face validity of two high-fidelity VR arthroscopy simulators.
• To evaluate simulators with passive versus active haptic feedback technology.

Main Methods:

• 38 participants (intermediate and expert) used two VR simulators: Simbionix ARTHRO Mentor (active haptics) and VirtaMed ArthroS (passive haptics).
• A 12-point diagnostic knee arthroscopy module was completed on each simulator.
• Participants then completed a validated face validity questionnaire.

Main Results:

• The passive haptic ArthroS simulator achieved satisfactory face validity scores (≥7.0) across all domains (external appearance, intra-articular appearance, instrumentation).
• The active haptic ARTHRO Mentor simulator failed to achieve face validity in all domains.
• ArthroS was significantly more realistic (p < 0.001) than ARTHRO Mentor, especially regarding haptic feedback from intra-articular structures.

Conclusions:

• Current active haptic technology in VR arthroscopy simulators lacks sufficient face validity.
• Passive haptic systems, utilizing textured rubber phantoms, provide a more realistic training experience.
• This enhanced realism benefits both intermediate and expert arthroscopists.