Virtual reality in paediatrics orthopaedics management: A scoping review
Hiya Grover, Teresa Sobocinska, Paul KarayiannisObjective
Paediatric orthopaedic care requires multifactorial approaches, with treatments potentially evoking anxiety and pain in patients. Distraction techniques like virtual reality (VR) have been adopted in adult care; however, their application to paediatrics remains limited. Given younger patients’ familiarity with digital tools, VR could offer a promising method to improve clinical outcomes. This study aims to identify types of VR-related interventions used in paediatric orthopaedics, and highlight target demographics, pathologies, procedures, and patient outcome measures.
Method
A scoping review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses - Statement for Scoping reviews (PRISMA-ScR) guidelines were undertaken. Key search terms and medical subheadings (MeSH) were identified through a preliminary search, and a comprehensive search strategy was applied across three databases for literature published from 2010-2025. Two reviewers independently screened titles, extracted, and analysed data.
Results
From 554 identified studies, 20 met eligibility criteria for extraction. Two distinct themes emerged: VR used during specific procedures (9 studies) and VR applied in rehabilitation (10 studies). Types of VR included augmented reality, immersive reality, and semi-immersive VR. Technologies used ranged from LEAP motion controllers and kinetic sensors to LED or TV projectors, motion controllers, and noise-blocking headphones. Across 20 studies, 5 reported statistically significant improvements with VR interventions compared to control groups, particularly in pain, anxiety, motor function, and rehabilitation outcomes, while another 5 demonstrated mixed effects across measured domains. However, 6 found no statistically significant difference over controls, and 3 reported VR performed equally to control interventions. 7 Studies noted adverse effects like nausea, discomfort, or disengagement, and 9 studies reported on feasibility.
Conclusions
Given the heterogenous study designs, reporting, and outcomes measured, these findings should act as an early example of the field of VR in paediatric orthopaedics, rather than as an evaluation of intervention effectiveness. Future work should define types of VR and establish a set of standardised outcome metrics to evaluate clinical success, feasibility, and cost effectiveness.