Pacira Pharmaceuticals has dipped into the virtual reality world to teach infiltration skills to orthopedic surgeons who need a deft touch and precision in administering a non-opioid pain management drug into tissue layers during total knee replacement surgery.

This seemingly simple injection is crucial in enabling patients to have relief from pain as they recover from the procedure. It requires careful precision by the surgeons doing the procedure, and previously, the only way to gain experience has been through doing the injections on actual patients.

However, Pacira developed a hands-on virtual reality training simulation, which it recently debuted at the annual meeting of the American Association of Hip and Knee Surgeons.

The company said it developed the virtual training tool to provide hands-on experience in a realistic but risk-free computer generated environment. Used to experience the injection of its drug, Exparel, in total knee arthroplasty (TKA), the simulation provides real-time haptic feedback technology to create a realistic experience.

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Pacira developed the platform in partnership with a steering committee of orthopedic surgeons currently utilizing its drug for knee replacement patients’ postsurgical pain management to ensure the specifics of the infiltration process are appropriately captured and the simulation accurately replicates the real-world clinician experience.

Beyond being visually immersed in the virtual infiltration procedure, a haptic stylus enables users to experience the sensation of injecting the drug into varying tissue layers and types. Users receive real-time feedback with visual heat maps showing their actual infiltration results, compared with the ideal distribution of Exparel throughout the surgical site.

“As a clinician who has experienced first-hand the impact of an enhanced recovery protocol in my total knee arthroplasty patients, I have found the addition of Exparel as part of a robust periarticular injection to be instrumental in pain relief and in patients’ postsurgical recovery,” said steering committee member Stan Dysart, MD, who is a practicing orthopedic surgeon at Wellstar Kennestone and Pinnacle Orthopaedics in Marietta, Ga., who helped refine and perfect the simulation.

To further support clinician education, Pacira is launching a new virtual training engine developed in collaboration with the mobile training platform Touch Surgery. The gaming experience provides users with the on-demand ability to practice infiltrating the pain management drug in a TKA by manipulating the exposure and angle of the knee, the angle of the syringe, the location of the injections, and the amount of volume distributed throughout the surgical site, all from the convenience of their smartphone or iPad. The Touch Surgery mobile app is available for free-of-charge download on iTunes, and will soon be released for the Android platform.

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