Editorial Commentary: Expansion of Hip Arthroscopy in Sports Medicine Fellowship Training: The Good, Bad, and Ugly

Editorial Commentary: Virtual Reality Simulation Can Help Arthroscopic Hip Preservation Surgeons at All Levels of Training and Practice-This is How

Virtual reality (VR) simulation has enormous potential utility in technically demanding manual activities. Hip arthroscopy is a perfect example of a challenging surgical technique with an extensive learning curve. The literature has recently consistently demonstrated that both career and annual maintenance case volume significantly influences patient-reported outcomes and risk of revision surgery and complications. Current residency and fellowship programs do not sufficiently prepare trainees to meet or exceed experience thresholds, so augmentation of training is necessary. A significant strength of VR simulation includes its ability to practice without limits. Unfortunately, hip models are limited to simple tasks, without full surgery models yet available simulating routine arthroscopic hip preservation procedures like labral repair, cam and pincer correction, capsular repair. Advanced techniques like labral reconstruction or augmentation, protrusio acetabulae, extensive cam morphology, revision surgery, peritrochanteric space endoscopy, and deep gluteal space endoscopy are not yet available for simulation. VR simulation can probably achieve competence for most, if not all, surgeons; possibly achieve proficiency; and unlikely to achieve mastery. The use of machine learning and artificial intelligence can process vast quantities of photo and video data to generate high-fidelity, lifelike surgical simulation. The near future will incorporate and assimilate these technologies cost-effectively for training programs and surgeons. Our patients will benefit.