3D-Printed Knee Arthroscopy Simulator (Scientific Validation Study)

This project presents a 3D-printed knee arthroscopy simulator developed for medical education and surgical training.

The simulator was designed to provide an accessible, reproducible and low-cost training platform that allows students and early trainees to practice fundamental arthroscopic skills such as camera navigation, triangulation and anatomical identification.

Unlike many low-cost training models, this simulator has been scientifically validated, demonstrating objective transfer of skills from simulation training to real arthroscopic procedures.

Scientific Validation

The simulator was evaluated in a randomized controlled study involving 40 final-year medical students with no prior arthroscopy experience.

Participants were divided into:

• Simulator training group
• Control group receiving only video instruction

Students trained with the simulator demonstrated significantly better performance during real diagnostic knee arthroscopy.

Main findings included:

• 39% reduction in procedure time
• 60% fewer lookdowns
• 59% fewer supervisor interventions
• 35% reduction in triangulation time
• 50% fewer instrument losses
• Higher ASSET scores in most evaluated domains

These results demonstrate effective transfer of surgical skills from simulation training to real surgical performance.

Scientific publication:

https://pubmed.ncbi.nlm.nih.gov/41091645/

The study describing the validation of this simulator can be consulted in detail

Simulator Structure

The simulator reproduces the anatomy of a human knee positioned at 90° flexion and consists of three main structural components:

• Proximal tibia with integrated base
• Distal femur
• External box with arthroscopic portals

The external box contains four portal openings, allowing insertion of the arthroscopic camera and probe and enabling training of triangulation and diagnostic arthroscopy maneuvers.

The simulator was intentionally designed to be easy to reproduce using consumer-grade 3D printers.

Authors of the Scientific Study

Paul André Alain Milcent
José Aguiomar Foggiatto
André Luís Mion
Carolline Popovicz Nunes
Camila Peixoto Fabri Milcent
Alynson Larocca Kulcheski
Mário Namba
Edmar Stieven Filho

Arthroscopic Camera

This simulator is designed to be used with the 3D-printed arthroscopic camera housing, available here:

https://www.printables.com/model/534010-3d-printed-arthroscopic-camera-validated-training

Femoral Model – Fixation System

The femoral component is fixed to the simulator base using a nut-and-bolt fixation system.

Two versions of the model are provided to accommodate different nut thicknesses:

7 mm model
Compatible with a standard M6 hex nut (~7 mm thickness). - link 

3 mm model
Compatible with a thin M6 nut (~3 mm thickness)  - link

Below, the picture shows an M6 nut with 3 mm thickness.

Fixation is completed using an M6 × 20-50 mm wing screw, allowing easy tightening and release without tools.

Fabrication of the Meniscus

The meniscus component is produced using a 3D-printed mold.

Currently, the preferred material for producing the meniscus is ballistic gelatin, which has proven to work very well for simulation purposes while being much easier to prepare and manage than silicone.

Advantages of ballistic gelatin:

• Easy and fast preparation
• Low cost
• Good tactile feedback for arthroscopic probing
• Easy replacement when worn out

Alternative material (used in the study):

Silicone molding rubber with catalyst can also be used if a more durable model is desired.

Basic silicone fabrication process:

1. Apply mold-release paste inside the mold

2. Prepare silicone mixture with catalyst

3. Pour silicone into the mold

4. Allow curing for approximately 24 hours

5. Carefully remove the silicone meniscus

Educational Purpose

This simulator was developed as an educational tool for surgical training.

It is intended to complement, not replace, formal surgical education and supervised clinical practice.

The goal is to increase access to arthroscopic training while maintaining a low production cost and high reproducibility.

Design Attribution

The development of the simulator involved collaboration between engineering and surgical expertise.

José Aguiomar Foggiatto, PhD
Mechanical Engineer
Professor – Federal Technological University of Paraná (UTFPR), Brazil

Professor Foggiatto supervised the engineering development of the simulator and contributed to the structural design and mechanical concepts used in the system.

André Luís Mion
Mechanical Engineering Student – UTFPR

The meniscal models and molds were designed by André Luís Mion, under the supervision of Prof. Foggiatto.

Edmar Stieven Filho, MD, MSc, PhD
Orthopedist and Traumatologist
Professor – Federal University of Paraná (UFPR), Brazil

The knee structural model and arthroscopic box geometry were adapted and refined by Edmar Stieven Filho to ensure anatomical fidelity and compatibility with real arthroscopic surgical workflow.

This collaboration allowed the simulator to combine engineering precision with clinical realism, resulting in a reproducible and scientifically validated training platform.