Mae Tatsuo, Nakata Ken, Kumai Tsukasa, Ishibashi Yasuyuki, Suzuki Tomoyuki, Sakamoto Takamitsu, Ohori Tomoki, Hirose Takehito, Yoshikawa Hideki
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.
Faculty of Sports Sciences, Waseda University, Japan. 2-579-15, Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
J Exp Orthop. 2019 Jul 25;6(1):35. doi: 10.1186/s40634-019-0203-7.
Ultrasonic (US) devices are used in laparoscopic, dental, and spinal surgeries, while it is difficult to use for the joint under irrigation and perfusion solutions due to lack of power. A new US device is developed with greater voltage improvement and has been implemented in the arthroscopic field. The aim is to compare the characteristics of the US devices with the conventional ones in water.
Twenty bone blocks from the porcine femur were settled in a holder in water. A 4.0 mm diameter abrader burr moved 15 mm along the long axis of the bone block in ten blocks for three times. A 4.3 mm wide curette blade powered by ultrasonic vibration was moved in the same manner in the other ten blocks. The gutter shape, including the gutter depth and the bottom angle of the gutter, and the curetted area ratio of the gutter were assessed. Forty bones blocks from the porcine femurs were clamped with a holder in water, while the cortical bone surface must be located on the side. A 5 mm diameter drill excavated the bone along the previously-inserted guide wire to the 15 mm depth for twenty blocks. Next, the US excavation probe of 5x4mm rectangular shape was moved to the same depth in the other twenty blocks. Each ten block was cut in half along the bone tunnel and was assessed the surface roughness at three area, while the cross-sectional area (CSA) of the tunnel were measured and the ratio of the measured CSA was calculated based on an expected CSA in the remaining ten blocks for each device.
The depth of curettage and bottom angle were significantly smaller with the US device than with the abrader burr at all planes, while the curetted area ratio created by each device was mostly equal to the other. Surface roughness was similar in two evacuating devices except one area. CSA ratio with the US excavation device was significantly smaller than that with the drill.
US curettage has an advantage to flatly curette bone surfaces, while a bone tunnel can be accurately created with the US device.
超声（US）设备用于腹腔镜、牙科和脊柱手术，但由于缺乏动力，在有冲洗和灌注液的关节手术中难以使用。一种新型超声设备在电压方面有了更大改进，并已应用于关节镜领域。目的是在水中比较该超声设备与传统设备的特性。
将20个猪股骨骨块固定在水中的支架上。直径4.0毫米的磨头在10个骨块中沿骨块长轴移动15毫米，重复3次。由超声振动驱动的4.3毫米宽的刮匙刀片在另外10个骨块中以相同方式移动。评估沟槽形状，包括沟槽深度和沟槽底角，以及沟槽的刮除面积比。将40个猪股骨骨块用支架固定在水中，皮质骨表面必须位于侧面。直径5毫米的钻头沿预先插入的导丝在20个骨块中钻至15毫米深度。接下来，将5×4毫米矩形的超声钻孔探头在另外20个骨块中钻至相同深度。每10个骨块沿骨隧道切成两半，在三个区域评估表面粗糙度，同时测量隧道横截面积（CSA），并根据每个设备其余10个骨块的预期CSA计算测量CSA的比例。
在所有平面上，超声设备的刮除深度和底角均显著小于磨头，而各设备产生的刮除面积比大多彼此相等。除一个区域外，两种钻孔设备的表面粗糙度相似。超声钻孔设备的CSA比例显著小于钻头的CSA比例。
超声刮除在平整骨表面刮除方面具有优势；同时，超声设备能够精确制造骨隧道。
