Orthopaedic Department, University of Zurich, Balgrist Hospital, Zurich, Switzerland.
Arthroscopy. 2012 Oct;28(10):1497-503. doi: 10.1016/j.arthro.2012.03.006. Epub 2012 Jun 9.
The purposes of this study were (1) to establish a reproducible, standardized testing protocol to evaluate the performance of different shaver systems and blades in a controlled, laboratory setting, and (2) to determine the optimal use of different blades with respect to the influence of contact pressure and speed of blade rotation.
A holding device was developed for reproducible testing of soft-tissue (tendon and meniscal) resection performance in a submerged environment, after loading of the shaver with interchangeable weights. The Karl Storz Powershaver S2 (Karl Storz, Tuttlingen, Germany), the Stryker Power Shaver System (Stryker, Kalamazoo, MI), and the Dyonics Power Shaver System (Smith & Nephew, Andover, MA) were tested, with different 5.5-mm shaver blades and varied contact pressure and rotation speed. For quality testing, serrated shaver blades were evaluated at 40× image magnification. Overall, more than 150 test cycles were performed.
No significant differences could be detected between comparable blade types from different manufacturers. Shavers with a serrated inner blade and smooth outer blade performed significantly better than the standard smooth resectors (P < .001). Teeth on the outer layer of the blade did not lead to any further improvement of resection (P = .482). Optimal contact pressure ranged between 6 and 8 N, and optimal speed was found to be 2,000 to 2,500 rpm. Minimal blunting of the shaver blades occurred after soft-tissue resection; however, with bone resection, progressive blunting of the shaver blades was observed.
Arthroscopic shavers can be tested in a controlled setting. The performance of the tested shaver types appears to be fairly independent of the manufacturer. For tendon resection, a smooth outer blade and serrated inner blade were optimal.
This is one of the first established independent and quantitative assessments of arthroscopic shaver systems and blades. We believe that this study will assist the surgeon in choosing the optimal tool for the desired effect.
本研究的目的是（1）建立一种可重复、标准化的测试方案，以在受控的实验室环境中评估不同的切割系统和刀片的性能，以及（2）确定在接触压力和刀片旋转速度的影响下，不同刀片的最佳使用方法。
开发了一种夹持装置，用于在水下环境中可重复地测试软组织（肌腱和半月板）切除性能，在对切割器加载可互换的重量后。测试了 Karl Storz Powershaver S2（Karl Storz，德国图特林根）、Stryker Power Shaver 系统（Stryker，密歇根州卡拉马祖）和 Dyonics Power Shaver 系统（Smith & Nephew，马萨诸塞州安多弗），使用了不同的 5.5mm 切割器刀片，并改变了接触压力和旋转速度。为了进行质量测试，锯齿状切割刀片在 40×图像放大倍数下进行了评估。总共进行了 150 多次测试循环。
不同制造商生产的类似刀片类型之间没有发现显著差异。带有锯齿状内刀片和平滑外刀片的切割器的性能明显优于标准的平滑切割器（P<0.001）。刀片外表面的齿没有进一步提高切割效果（P=0.482）。最佳接触压力范围在 6 至 8N 之间，最佳速度为 2000 至 2500rpm。软组织切除后，切割器刀片的磨损最小；然而，在进行骨切除时，切割器刀片的磨损逐渐增加。
关节镜下切割器可以在受控环境中进行测试。测试的切割器类型的性能似乎与制造商无关。对于肌腱切除，光滑的外刀片和锯齿状的内刀片是最佳选择。
这是对关节镜下切割系统和刀片进行的首次独立、定量评估之一。我们相信，这项研究将有助于外科医生选择达到预期效果的最佳工具。
