DOI: 10.1093/bjs/znad258.576 ISSN:

657 Evaluating the Effectiveness of Virtual Reality for Arthroplasty Training in Orthopaedic Trainees: A Systematic Review

O Adebayo, W Beedham, I Millward, M Gandhi
  • Surgery



Virtual Reality (VR) provides high-fidelity simulation, enabling trainees to practice surgical procedures whilst reducing patient risk. The focus in orthopaedic literature has been on basic surgical skills and arthroscopic procedures. Research into arthroplasty simulation resources is under-represented.

This systematic review assesses current literature on the effectiveness of VR for arthroplasty training.


A systematic literature search was conducted across all relevant bibliographic databases. Randomised controlled trials (RCTs) meeting the inclusion criteria were selected and assessed by three independent reviewers. The primary outcome was the standardised mean difference (SMD) in either the global rating score or task-specific checklists at pre/post-intervention. This outcome was extracted using a piloted data extraction tool. Studies were assessed for risk of bias using a piloted risk of bias tool.


628 studies were identified, of which 624 did not meet the inclusion criteria. The four studies included in the meta-analysis displayed a trend that VR improved surgical competence more than existing methods (SMD 1.57, 95% CI [-0.45 to 3.59]; P = 0.13).

Secondary outcomes in all studies showed VR improved trainee confidence and provided a more enjoyable experience.


VR improved surgical competency and improved trainee confidence in performing arthroplasty procedures, therefore indicating that this training modality could benefit both trainees and patients in the future. However, there is a paucity of evidence for VR in arthroplasty training, making results less precise and creating significant inter-study heterogeneity. This highlights the need for further high-quality RCTs to be produced assessing the effectiveness of VR for arthroplasty training.

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