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Arthroscopic Basic Task Performance in Shoulder Simulator Model Correlates with Similar Task Performance in Cadavers
Kevin D. Martin, DO1; Philip J. Belmont, Jr., MD1; Andrew J. Schoenfeld, MD1; Michael Todd, DO1; Kenneth L. Cameron, PhD, ATC2; Brett D. Owens, MD2
1 William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920
2 Keller Army Hospital, 900 Washington Road, West Point, NY 10996. E-mail address for B.D. Owens: b.owens@us.army.mil
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Investigation performed at William Beaumont Army Medical Center, El Paso, Texas
Disclaimer: The views and opinions expressed in this manuscript are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Nov 02;93(21):e127 1-5. doi: 10.2106/JBJS.J.01368
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Attainment of the technical skill necessary to safely perform arthroscopic procedures requires the instruction of orthopaedic surgery residents in basic arthroscopic skills. Although previous studies involving shoulder arthroscopy simulators have demonstrated a correlation between task performance and the level of prior arthroscopic experience, data demonstrating the correlation of simulator performance with arthroscopic skill in a surgical setting are scarce. Our goal was to evaluate the correlation between timed task performance in an arthroscopic shoulder simulator and timed task performance in a cadaveric shoulder arthroscopy model.


Subjects were recruited from among residents and attending surgeons in an orthopaedic surgery residency program. Each subject was tested on an arthroscopic shoulder simulator and objectively scored on the basis of the time taken to complete a standardized object selection program. After an interval of at least two weeks, each subject was then tested on a cadaveric shoulder arthroscopy model designed to replicate the shoulder arthroscopy simulator testing protocol, and the time to completion was again recorded. Both testing protocols involved the simple task of placing a probe on a series of assigned locations in the glenohumeral joint. Spearman rank correlation analysis was performed, and regression analysis was used to determine the predictive ability of the simulator score.


The performance time on the simulation program was strongly correlated with the performance time on the cadaveric model (r = 0.736, p < 0.001). The time required to complete the simulator task was a significant predictor of the time required to complete the cadaveric task (t = 4.48, p < 0.001).


These results demonstrated a strong correlation between performance of basic arthroscopic tasks in a simulator model and performance of the same tasks in a cadaveric model.

Clinical Relevance: 

This study suggests that performance of basic arthroscopic tasks in a simulator environment may be indicative of performance of similar arthroscopic tasks in a surgical setting. This work supports the continued study of arthroscopy simulators as a potentially beneficial educational tool.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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