The Grapefruit: An Alternative Arthroscopic Tool Skill Platform

David A. Molho, Stephen M. Sylvia, Daniel L. Schwartz, Sara L. Merwin, I. Martin Levy

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose To establish the construct validity of an arthroscopic training model that teaches arthroscopic tool skills including triangulation, grasping, precision biting, implant delivery and ambidexterity and uses a whole grapefruit for its training platform. Methods For the grapefruit training model (GTM), an arthroscope and arthroscopic instruments were introduced through portals cut in the grapefruit skin of a whole prepared grapefruit. After institutional review board approval, participants performed a set of tasks inside the grapefruit. Performance for each component was assessed by recording errors, achievement of criteria, and time to completion. A total of 19 medical students, orthopaedic surgery residents, and fellowship-trained orthopaedic surgeons were included in the analysis and were divided into 3 groups based on arthroscopic experience. One-way analysis of variance (ANOVA) and the post hoc Tukey test were used for statistical analysis. Results One-way ANOVA showed significant differences in both time to completion and errors between groups, F(2, 16) = 16.10, P <.001; F(2, 16) = 17.43, P <.001. Group A had a longer time to completion and more errors than group B (P =.025, P =.019), and group B had a longer time to completion and more errors than group C (P =.023, P =.018). Conclusions The GTM is an easily assembled and an alternative arthroscopic training model that bridges the gap between box trainers, cadavers, and virtual reality simulators. Our findings suggest construct validity when evaluating its use for teaching the basic arthroscopic tool skills. As such, it is a useful addition to the arthroscopic training toolbox. Clinical Relevance There is a need for validated low-cost arthroscopic training models that are easily accessible.

Original languageEnglish (US)
Pages (from-to)1567-1572
Number of pages6
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Issue number8
StatePublished - Aug 2017

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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