Virtual Reality Is an Effective Tool for Learning Techniques in Arthroplasty: A Systematic Review and Meta-Analysis

Background: There is a scarcity of aggregate literature reporting on the efficacy of virtual reality (VR) concerning surgical skill development within the realm of arthroplasty. The purpose of this study was to evaluate the effect of VR on the training of orthopaedic surgery residents and medical students learning surgical techniques in arthroplasty. Methods: A systematic review was conducted querying PubMed, Cochrane Trials, and Embase in September 2022. Studies were included if they involved education or training of orthopaedic surgery residents/students, used VR, and reported on outcomes measuring surgical skills related to arthroplasty. Outcomes present in a minimum of three studies underwent additional statistical analysis with forest plots. Results: Seven studies met inclusion criteria and included a total sample size of 148 residents/students between MS4-PGY6. Five of the seven included studies showed VR to be an effective training modality, with two studies demonstrating that VR reduced the error rate (P < 0.05). The two most reported outcomes were procedure duration and objective structured assessment of technical skills. Orthopaedic trainees using VR conducted procedures in markedly less time than control groups (SMD, −0.81 minute; 95% confidence interval, [−1.45 to −0.17 minutes]; P = 0.01). No significant difference was found comparing objective structured assessment of technical skills between VR and control groups (SMD, 0.44; 95% confidence interval, [−1.05 to 1.93]; P = 0.56). Conclusion: Although the extent to which VR can outright replace standard learning modalities is unclear at this time, its usefulness as a supplemental learning modality in arthroplasty, especially in the absence of available on-demand resources, may be of value. A paucity of literature exists to evaluate the effect of a longitudinal VR curriculum on direct patient care performance by orthopaedic surgery residents learning techniques in arthroplasty, necessitating additional study.