Phillips Lisa, Cheung Jeffrey J H, Whelan Daniel B, Murnaghan Michael Lucas, Chahal Jas, Theodoropoulos John, Ogilvie-Harris Darrell, Macniven Ian, Dwyer Tim
Women's College Hospital, Toronto, Ontario, Canada.
University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada.
Am J Sports Med. 2017 Jul;45(9):2125-2130. doi: 10.1177/0363546517696316. Epub 2017 Mar 29.
Arthroscopic hip labral repair is a technically challenging and demanding surgical technique with a steep learning curve. Arthroscopic simulation allows trainees to develop these skills in a safe environment.
The purpose of this study was to evaluate the use of a combination of assessment ratings for the performance of arthroscopic hip labral repair on a dry model.
Cross-sectional study; Level of evidence, 3.
A total of 47 participants including orthopaedic surgery residents (n = 37), sports medicine fellows (n = 5), and staff surgeons (n = 5) performed arthroscopic hip labral repair on a dry model. Prior arthroscopic experience was noted. Participants were evaluated by 2 orthopaedic surgeons using a task-specific checklist, the Arthroscopic Surgical Skill Evaluation Tool (ASSET), task completion time, and a final global rating scale. All procedures were video-recorded and scored by an orthopaedic fellow blinded to the level of training of each participant.
The internal consistency/reliability (Cronbach alpha) using the total ASSET score for the procedure was high (intraclass correlation coefficient > 0.9). One-way analysis of variance for the total ASSET score demonstrated a difference between participants based on the level of training ( F = 27.8, P < .001). A good correlation was seen between the ASSET score and previous exposure to arthroscopic procedures ( r = 0.52-0.73, P < .001). The interrater reliability for the ASSET score was excellent (>0.9).
The results of this study demonstrate that the use of dry models to assess the performance of arthroscopic hip labral repair by trainees is both valid and reliable. Further research will be required to demonstrate a correlation with performance on cadaveric specimens or in the operating room.
关节镜下髋关节盂唇修复术是一项技术上具有挑战性且要求较高的手术技术，学习曲线较陡。关节镜模拟可让受训人员在安全环境中培养这些技能。
本研究的目的是评估在干燥模型上进行关节镜下髋关节盂唇修复术时综合评估评分的应用情况。
横断面研究；证据等级，3级。
共有47名参与者，包括骨科住院医师（n = 37）、运动医学研究员（n = 5）和外科主治医师（n = 5）在干燥模型上进行关节镜下髋关节盂唇修复术。记录先前的关节镜经验。由2名骨科医生使用特定任务清单、关节镜手术技能评估工具（ASSET）、任务完成时间和最终整体评分量表对参与者进行评估。所有手术均进行视频记录，并由一名对每位参与者的培训水平不知情的骨科研究员进行评分。
使用该手术的ASSET总分的内部一致性/可靠性（Cronbach α）较高（组内相关系数> 0.9）。对ASSET总分进行的单因素方差分析表明，基于培训水平，参与者之间存在差异（F = 27.8，P < .001）。ASSET评分与先前接触关节镜手术之间存在良好的相关性（r = 0.52 - 0.73，P < .001）。ASSET评分的评分者间可靠性极佳（> 0.9）。
本研究结果表明，使用干燥模型评估受训人员关节镜下髋关节盂唇修复术的表现是有效且可靠的。需要进一步研究以证明与尸体标本或手术室中的表现存在相关性。
