Developing a Total Knee Arthroplasty Simulator: A Qualitative Study to Find the Best Model

Mojtaba Khajeh  Alizadeh Attar; Nastaran  Maghbouli; Kaveh  Same; Fardis  Vosoughi; Amirabbas  Nikkhah; Amir  Ghaffari; Najmeh  Foroughi; Farhoud Saeid  Ershadi; Mohammad Hossein  Nabian; Leila Oryadi  Zanjani

doi:10.18502/jimc.v9i1.20489

Mojtaba Khajeh Alizadeh Attar Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Nastaran Maghbouli Department of Physical Medicine and Rehabilitation, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Kaveh Same Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Fardis Vosoughi Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Amirabbas Nikkhah Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Amir Ghaffari Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Najmeh Foroughi Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Farhoud Saeid Ershadi Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Hossein Nabian Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
Leila Oryadi Zanjani Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v9i1.20489

Keywords: Ankle, Arthroplasty, Feedback, Fellowships and Scholar-ships, Focus groups, Grounded theory, Hip joint, Hospitals, Patient safety, Tendons

Abstract

Background: Concerns about patient safety, resident work hour restrictions, and recent technology improvements have increased interest in surgical simulations. This study was designed to find the most effective and applicable model for total knee arthroplasty simulator.

Methods: This is a qualitative study using Focus Group Discussion (FGD) to collect data and grounded theory for analysis. A topic guide including main questions in a structured approach was used by the moderators. Three FGD sessions were held using video chat. Session’s content was recorded and extracted data was analyzed by inductive content analysis method.

Results: Eligible 5 orthopedic residents, 4 orthopedic fellowships, and 7 academic professors from referral tertiary center hospital were interviewed. The main domains of discussion were about the necessity of a Total Knee Arthroplasty (TKA) simulator, virtual vs. physical model, bone and soft tissue characteristics, and the feedback system. Twelve percent of the participants believed a virtual model has more advantages while the others thought physical model is more applicable and 12% of them suggested a mixed model. Gap balancing was noticed as a crucial part by 40% of the participants to be included in the model.

Conclusion: All the participants deemed the existence of a simulator for TKA necessary. The essential parts of the TKA simulator like foot, ankle, hip, soft tissue elements, ligaments and tendons (especially collateral ligaments) were emphasized. To improve the simulator, the participants suggested that it should have a modular design and also sensors to alarm any damage to the vital elements. Also, they pointed out having feedback option for development of TKA simulator.