Department of Mechanical Engineering, Texas A&M University, College Station, Texas, USA.
Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.
J Orthop Res. 2023 Feb;41(2):378-385. doi: 10.1002/jor.25377. Epub 2022 May 28.
The purpose of this study is to propose a quantitative assessment scheme to help with surgical bone drilling training. This pilot study gathered and compared motion and force data from expert surgeons (n = 3) and novice residents (n = 6). The experiment used three-dimensional printed bone simulants of young bone (YB) and osteoporotic bone (OB), and drilling overshoot, time, and force were measured. There was no statistically significant difference in overshoot between the two groups (p = 0.217 for YB and 0.215 for OB). The results, however, show that the experts took less time (mean = 4.01 s) than the novices (mean = 9.98 s), with a statistical difference (p = 0.003 for YB and 0.0001 for OB). In addition, the expert group performed more consistently than the novices. The force analysis further revealed that experts used a higher force to drill the first cortical section and a noticeably lower force in the second cortex to control the overshoot (approximate reduction of 5.5 N). Finally, when drilling time and overshoot distance were combined, the motion data distinguished the skill gap between expert and novice drilling; the force data provided insight into the drilling mechanism and performance outcomes. This study lays the groundwork for a data-driven training scheme to prepare novice residents for clinical practice.
本研究旨在提出一种定量评估方案,以帮助进行外科骨钻训练。本初步研究收集并比较了专家外科医生(n=3)和新手住院医师(n=6)的运动和力数据。实验使用了年轻骨(YB)和骨质疏松骨(OB)的三维打印骨模拟物,并测量了钻过头、时间和力。两组之间的钻过头没有统计学上的显著差异(p=0.217 用于 YB,p=0.215 用于 OB)。然而,结果表明专家所用的时间比新手少(YB 平均=4.01s,OB 平均=9.98s),差异具有统计学意义(p=0.003 用于 YB,p=0.0001 用于 OB)。此外,专家组的表现比新手更一致。力分析进一步表明,专家在钻第一皮质骨时使用了更高的力,而在第二皮质骨时使用了明显较低的力来控制钻过头(大约降低了 5.5N)。最后,当将钻削时间和钻过头距离结合起来时,运动数据区分了专家和新手之间的技能差距;力数据提供了对钻削机制和性能结果的深入了解。本研究为基于数据的培训方案奠定了基础,旨在为新手住院医师做好临床实践准备。