Miryam C Obdeijn1, Tim Horeman2, Lisanne L de Boer3, Sophie J van Baalen3, Philippe Liverneaux4, Gabrielle J M Tuijthof2,5. 1. Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands. m.c.obdeijn@amc.uva.nl. 2. Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands. 3. Department of Technical Medicine, MIRA Institute for Biomedical Technology and Technical Medicine Enschede, University of Twente, Enschede, Netherlands. 4. Department of Hand Surgery, Strasbourg University Hospitals, Illkirch, France. 5. Department of Orthopedic Surgery, Orthopedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
Abstract
PURPOSE: To facilitate effective and efficient training in skills laboratory, objective metrics can be used. Forces exerted on the tissues can be a measure of safe tissue manipulation. To provide feedback during training, expert threshold levels need to be determined. The purpose of this study was to define the magnitude and the direction of navigation forces used during arthroscopic inspection of the wrist. METHODS: We developed a set-up to mount a cadaver wrist to a 3D force platform that allowed measurement of the forces exerted on the wrist. Six experts in wrist arthroscopy performed two tasks: (1) Introduction of the camera and visualization of the hook. (2) Navigation through the wrist with visualization of five anatomic structures. The magnitude (Fabs) and direction of force were recorded, with the direction defined as α being the angle in the vertical plane and β being the angle in the horizontal plane. The 10th-90th percentile of the data were used to set threshold levels for training. RESULTS: The results show distinct force patterns for each of the anatomic landmarks. Median Fabs of the navigation task is 3.8 N (1.8-7.3), α is 3.60 (-54-44) and β is 260 (0-72). CONCLUSION: Unique expert data on navigation forces during wrist arthroscopy were determined. The defined maximum allowable navigation force of 7.3 N (90th percentile) can be used in providing feedback on performance during skills training. The clinical value is that this study contributes to objective assessment of skills levels.
PURPOSE: To facilitate effective and efficient training in skills laboratory, objective metrics can be used. Forces exerted on the tissues can be a measure of safe tissue manipulation. To provide feedback during training, expert threshold levels need to be determined. The purpose of this study was to define the magnitude and the direction of navigation forces used during arthroscopic inspection of the wrist. METHODS: We developed a set-up to mount a cadaver wrist to a 3D force platform that allowed measurement of the forces exerted on the wrist. Six experts in wrist arthroscopy performed two tasks: (1) Introduction of the camera and visualization of the hook. (2) Navigation through the wrist with visualization of five anatomic structures. The magnitude (Fabs) and direction of force were recorded, with the direction defined as α being the angle in the vertical plane and β being the angle in the horizontal plane. The 10th-90th percentile of the data were used to set threshold levels for training. RESULTS: The results show distinct force patterns for each of the anatomic landmarks. Median Fabs of the navigation task is 3.8 N (1.8-7.3), α is 3.60 (-54-44) and β is 260 (0-72). CONCLUSION: Unique expert data on navigation forces during wrist arthroscopy were determined. The defined maximum allowable navigation force of 7.3 N (90th percentile) can be used in providing feedback on performance during skills training. The clinical value is that this study contributes to objective assessment of skills levels.
Authors: M C Obdeijn; N Bavinck; C Mathoulin; C M A M van der Horst; M P Schijven; G J M Tuijthof Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-07-09 Impact factor: 4.342
Authors: Tim Horeman; Freek van Delft; Mathijs D Blikkendaal; Jenny Dankelman; John J van den Dobbelsteen; Frank-Willem Jansen Journal: Surg Endosc Date: 2014-02-12 Impact factor: 4.584
Authors: Tim Horeman; Mathijs D Blikkendaal; Daisy Feng; Arjan van Dijke; FrankWillem Jansen; Jenny Dankelman; John J van den Dobbelsteen Journal: J Surg Educ Date: 2013-09-18 Impact factor: 2.891
Authors: Tim Horeman; Sharon P Rodrigues; John J van den Dobbelsteen; Frank-Willem Jansen; Jenny Dankelman Journal: Surg Endosc Date: 2011-08-20 Impact factor: 4.584
Authors: Sharon P Rodrigues; Tim Horeman; Jenny Dankelman; John J van den Dobbelsteen; Frank-Willem Jansen Journal: Surg Endosc Date: 2011-10-25 Impact factor: 4.584
Authors: Nick F J Hilgersom; Tim Horeman-Franse; Ronald L A W Bleys; Denise Eygendaal; Michel P J van den Bekerom; Gabriëlle J M Tuijthof Journal: J Exp Orthop Date: 2018-10-11