Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, VT.
University of Vermont Medical School, Burlington, VT.
J Arthroplasty. 2020 Nov;35(11):3300-3304. doi: 10.1016/j.arth.2020.06.019. Epub 2020 Jun 15.
Oscillating saws are commonly used for bone preparation in total knee arthroplasty but can cause injury to the posterior neurovascular bundle during tibial resection. Tip-oscillating saw blades are a recent innovation that could improve saw control due to decreased excursion; however, the tactile feedback to the surgeon is different.
To compare traditional hub and new tip-oscillating saw blades, 16 participants of varying levels of experience were video-recorded during composite tibial bone model resections to measure posterior saw blade plunge. Subjective perceptions of saw control and preference were also surveyed.
Saw blade design and level of surgical experience did not produce a significant difference in posterior saw blade plunge (P > .05). Independent of saw blade design, subjects with no previous saw experience had significantly decreased posterior tibial plunge over subsequent resections. Tip-oscillating saw blades were perceived to be easier to use and control by less experienced participants (P = .0163).
Tip-oscillating saw blades do not alter the risk of posterior tibial saw plunge compared with traditional saw blades.
摆动锯常用于全膝关节置换术中的骨准备，但在胫骨切除过程中可能会损伤后神经血管束。尖端摆动锯片是一种最近的创新，可以通过减少摆动来改善锯的控制；然而，对外科医生的触觉反馈是不同的。
为了比较传统的轮毂和新的尖端摆动锯片，16 名不同经验水平的参与者在复合胫骨模型切除过程中被录像，以测量后侧锯片的插入深度。还对锯控制和偏好的主观感知进行了调查。
锯片设计和手术经验水平对后侧锯片插入深度没有显著差异（P>.05）。独立于锯片设计，没有以前锯切经验的受试者在后几次切除中后侧胫骨插入深度显著降低。经验较少的参与者认为尖端摆动锯片更容易使用和控制（P=0.0163）。
与传统锯片相比，尖端摆动锯片并不会改变后侧胫骨锯切的风险。
