A 3D-Printed Home-Based Arthroscopic Simulator Improves Basic Surgical Skills: A Prospective Comparative Multicentre Study

<b>Objectives</b>: Arthroscopic surgery requires complex visuospatial coordination and psychomotor skills, which are traditionally acquired through mentorship and cadaveric training. High-fidelity simulators are effective but often costly and inaccessible. This study evaluates the technical effectiveness of a novel home-based 3D-printed arthroscopic simulator ("Arthrozero") for improving basic arthroscopic skills among orthopedic residents. <b>Methods</b>: Thirty-three orthopedic residents (25-36 years) from two Italian university centers were randomized into three groups: ZERO (Arthrozero training), ARTHRO (real arthroscope training), and CONTROL (theoretical session). Training was performed on a FAST-like workstation through four progressively complex tasks. Performance metrics included task completion time, number of looks down, and skill progression during a final Shoulder Challenge (SHO-CHA) assessment. A web-based Likert questionnaire evaluated participant satisfaction and perceived educational value. <b>Results</b>: Both ZERO and ARTHRO groups demonstrated significant improvement across training sessions (<i>p</i> < 0.05) for all tasks, while the CONTROL group showed minimal gains. In the SHO-CHA assessment, mean completion times were 394.1 ± 140.7 s (ZERO), 456.1 ± 123.2 s (ARTHRO), and 745.5 ± 190.7 s (CONTROL) (<i>p</i> < 0.01). No significant difference was observed between ZERO and ARTHRO groups (<i>p</i> = 0.276). <b>Conclusions</b>: The home-based Arthrozero simulator demonstrated improvements in basic arthroscopic skill performance, suggesting that it may represent an accessible training tool to support early arthroscopic skill acquisition alongside traditional training methods.