Porsch M, Schmidt J
Department of Orthopaedics, University of Cologne, Germany.
Arch Orthop Trauma Surg. 2001 May;121(5):274-7. doi: 10.1007/s004020000233.
In this paper, we introduce a newly developed miniaturised chiselling system (Swiss OrthoClast) which allows endoscopically controlled cement removal even from deep within the femur in hip revision arthroplasty. The intraoperative handling is demonstrated and illustrated. The device consists of a control unit, a handpiece, a set of chisels of different lengths, shape, and tip geometry, a set of plug extraction tools, and a special intrafemoral endoscope. It uses simple ballistic principles to effect fracturing of the bone cement. Inside the handpiece the projectile is accelerated and strikes the chisel head. The tip moves at high speed and with a small excursion towards the cement, which is fragmented mechanically by the movement of the chisel tip without generating heat. The device is being validated in a prospective, international, multicenter study, and we include here the results of the first 28 clinical procedures of cement removal. The duration of the procedure varied from 13 to 75 min, with an average of 32 min. In all but one case, the cement was completely removed. We noted one case of cortical fissuring.
在本文中，我们介绍了一种新开发的小型凿骨系统（瑞士OrthoClast），该系统可在内窥镜控制下，甚至从髋关节翻修术中股骨深处取出骨水泥。文中展示并说明了该系统的术中操作方法。该设备由一个控制单元、一个手持件、一套不同长度、形状和尖端几何形状的凿子、一套塞子拔出工具以及一个特殊的股内内窥镜组成。它利用简单的弹道原理来破碎骨水泥。在手持件内部，射弹被加速并撞击凿头。凿头尖端高速移动并朝着骨水泥做小幅度移动，通过凿头尖端的运动将骨水泥机械性破碎，且不会产生热量。该设备正在一项前瞻性、国际性、多中心研究中进行验证，我们在此展示了前28例骨水泥取出临床手术的结果。手术时长从13分钟到75分钟不等，平均为32分钟。除1例之外，所有病例的骨水泥均被完全取出。我们记录到1例皮质骨裂隙。
