Purpose: The aims of this study were (1) to develop a three‐dimensional (3D) printed simulator that facilitates the simulation of surgical skills for portal placement, intra‐articular identification of anatomical structures and arthroscope navigation for hip arthroscopy and (2) to concurrently examine the feasibility of using this simulator as an assessment tool to evaluate trainees’ surgical competencies.Methods: A simulator was developed using a combination of medical imaging, computer‐aided design, and 3D printing. A cross‐sectional study was conducted with 29 participants divided into 3 subgroups (novice, intermediate and experienced). All participants performed related skills on the simulator, and their performance was evaluated using different assessment parameters. The participants’ qualitative feedback regarding the simulator was also collected. The data collated from each group of participants were subsequently compared.Results: Significant differences were observed between the three subgroups of participants with regard to the total checklist score (F_2,26 = 11.3), total Arthroscopic Surgical Skill Evaluation score (F_2,26 = 92.1), overall final global rating scale score (F_2,26 = 49), number of times the participants used fluoroscopy (F_2,26 = 7.4), and task completion times (F_2,26 = 23.5). The participants’ performance in the simulated operation was correlated with their prior clinical experience. There was mainly positive feedback with regard to the fidelity and utility of the simulator in relation to the surgeons’ prior clinical experience.Conclusions: This study demonstrated that a reliable hip arthroscopic simulator can be developed for use by orthopedic surgeons to evaluate their hip arthroscopic skills before performing actual surgical operations.Level of evidence: Level III.

This study aimed to investigate the feasibility of using eye tracking data to identify orthopedic trainees’ technical proficiency in hip arthroscopic procedures during simulation-based training. A cross sectional study. A simulation-based training session for hip arthroscopy was conducted. Eye tracking devices were used to record participants’ eye movements while performing simulated operations. The NASA Task Load Index survey was then used to measure subjective opinions on the perceived workload of the training. Statistical analyses were performed to determine the significance of the eye metrics and survey data. A total of 12 arthroscopic trainees, including resident doctors, junior specialist surgeons, and consultant surgeons from the Department of Orthopedics in five hospitals, participated in this study. They were divided into three subgroups based on their prior clinical experience. Significant differences, including those for dwell time, number of fixations, number of saccades, saccade duration, peak velocity of the saccade, and pupil entropy, were observed among the three subgroups. Additionally, there were clear trends in the perceived workload of the simulation-based training based on feedback from the participants. Based on this preliminary study, a correlation was identified between the eye tracking metrics and participants’ experience levels. Hence, it is feasible to apply eye tracking data as a supplementary objective assessment tool to benchmark the technical proficiency of surgical trainees in hip arthroscopy, and enhance simulation-based training.

Preoperative diagnosis of periprosthetic joint infection (PJI) is critical to guide treatment options and improve patient outcomes. In this letter, the authors discuss results from our experiences with a novel nomogram diagnosis model based on serum and synovial fluid indicators for the preoperative diagnosis of PJI. The results showed that the novel nomogram diagnosis model can distinguish PJI from aseptic loosening before the operation. And it is also a useful candidate for the selection of the timing of current secondary revision.