Department of Mechanical and Materials Engineering, Western University, London, ON, N6A 5B9, Canada.
Roth|McFarlane Hand and Upper Limb Centre, St. Josephs Health Care, Western University, 268 Grosvenor St., London, ON, N6A 4V2, Canada.
Int J Comput Assist Radiol Surg. 2018 Jul;13(7):1049-1062. doi: 10.1007/s11548-018-1734-6. Epub 2018 Mar 17.
Glenoid reaming is a technically challenging step during shoulder arthroplasty that could possibly be learned during simulation training. Creation of a realistic simulation using vibration feedback in this context is innovative. Our study focused on the development and internal validation of a novel glenoid reaming simulator for potential use as a training tool.
Vibration and force profiles associated with glenoid reaming were quantified during a cadaveric experiment. Subsequently, a simulator was fabricated utilizing a haptic vibration transducer with high- and low-fidelity amplifiers; system calibration was performed matching vibration peak-peak values for both amplifiers. Eight experts performed simulated reaming trials. The experts were asked to identify isolated layer profiles produced by the simulator. Additionally, experts' efficiency to successfully perform a simulated glenoid ream based solely on vibration feedback was recorded.
Cadaveric experimental cartilage reaming produced lower vibrations compared to subchondral and cancellous bones ([Formula: see text]). Gain calibration of a lower-fidelity (3.5 [Formula: see text] and higher-fidelity (3.4 [Formula: see text] amplifier resulted in values similar to the cadaveric experimental benchmark (3.5 [Formula: see text]. When identifying random tissue layer samples, experts were correct [Formula: see text] of the time and success rate varied with tissue type ([Formula: see text]). During simulated reaming, the experts stopped at the targeted subchondral bone with a success rate of [Formula: see text]. The fidelity of the simulation did not have an effect on accuracy, applied force, or reaming time ([Formula: see text]). However, the applied force tended to increase with trial number ([Formula: see text]).
Development of the glenoid reaming simulator, coupled with expert evaluation furthered our understanding of the role of haptic vibration feedback during glenoid reaming. This study was the first to (1) propose, develop and examine simulated glenoid reaming, and (2) explore the use of haptic vibration feedback in the realm of shoulder arthroplasty.
在肩关节置换术中，肩胛盂锉磨是一个技术上具有挑战性的步骤，可能可以通过模拟训练来学习。在这种情况下，使用振动反馈来创建逼真的模拟是创新的。我们的研究重点是开发和内部验证一种新的肩胛盂锉磨模拟器，以潜在地用作培训工具。
在尸体实验中，对肩胛盂锉磨相关的振动和力曲线进行了量化。随后，使用具有高保真度和低保真度放大器的触觉振动传感器制造了一种模拟器；通过匹配两个放大器的振动峰峰值来进行系统校准。八名专家进行了模拟锉磨试验。专家们被要求识别模拟器产生的独立层轮廓。此外，记录了专家仅根据振动反馈成功执行模拟肩胛盂锉磨的效率。
尸体实验软骨锉磨产生的振动低于软骨下骨和松质骨（[公式：见正文]）。对低保真度（3.5 [公式：见正文]和高保真度（3.4 [公式：见正文]放大器进行增益校准，结果与尸体实验基准值（3.5 [公式：见正文]相似。在识别随机组织层样本时，专家的正确率为[公式：见正文]，且成功率随组织类型而变化（[公式：见正文]）。在模拟锉磨过程中，专家在目标软骨下骨处停止，成功率为[公式：见正文]。模拟的逼真度对准确性、施加力或锉磨时间没有影响（[公式：见正文]）。然而，施加力随着试验次数的增加而增加（[公式：见正文]）。
肩胛盂锉磨模拟器的开发以及专家评估进一步加深了我们对肩胛盂锉磨过程中触觉振动反馈作用的理解。本研究首次（1）提出、开发和检验了模拟肩胛盂锉磨，以及（2）探索了触觉振动反馈在肩关节置换术中的应用。
