Virtual Reality in Orthopaedic Pre-Operative Trauma Planning: A Face and Content Validity Study
D Waugh1*, D Howie2, O Bailey2, R Bhattacharyya2
1West of Scotland Trauma and Orthopaedic Registrar, Glasgow, Scotland.
2NHS Lanarkshire Trauma and Orthopaedic Department, Wishaw, Scotland.
*Corresponding Author: Dominic Waugh, West of Scotland Trauma and Orthopaedic Registrar, Glasgow, Scotland.
https://doi.org/10.58624/SVOAOR.2025.05.024
Received: November 24, 2025
Published: December 18, 2025
Citation: Waugh D, Howie D, Bailey O, Bhattacharyya R. Virtual Reality in Orthopaedic Pre-Operative Trauma Planning: A Face and Content Validity Study. SVOA Orthopaedics 2025, 5:6, 148-154. doi: 10.58624/SVOAOR.2025.05.024
Abstract
Purpose: Virtual Reality (VR) has demonstrated value in surgical simulation and training, with emerging interest in its use for patient-specific pre-operative planning. Evidence evaluating VR systems for planning orthopaedic trauma surgery remains limited. There is little published on VR as a pre- operative planning tool in orthopaedic trauma surgery. After assembling a VR system utilising Medicalholodeck software to allow visualisation of stereoscopic 3D patient images with specific surgical implants in the same virtual space, we sought to collect early surgeon user data on the system’s face and content validity.
Methods: Following software assembly, hardware acquisition, and iterative testing, a local user guide and pilot questionnaire were developed. The survey was based on established VR validation frameworks and pilot-tested with surgeons for clarity. Surgeons reviewed CT imaging on PACS and then repeated assessment in VR. Immediate qualitative and quantitative responses were collected. From this, face and content validity was evaluated and a Net Promoter Score (NPS) were calculated.
Results: Twenty-four responses were obtained across surgeon grades. VR significantly improved surgeons’ understanding of fracture patterns (Wilcoxon signed-rank test: Z = –3.93, p<0.001, r = 0.59). All participants agreed that the VR representation matched PACS CT imaging, and 87% reported a change in operative plan. NPS was +71, with 75% promoters.
Conclusion: This early evaluation demonstrates strong face and content validity for a low-cost VR trauma planning tool. Further work will assess accuracy of implant templating and evaluate the system’s role in patient explanation and consent.
Keywords: Virtual Reality, Orthopaedic Trauma Surgery, Pre-operative Planning, Surgical Simulation