Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Orthop Surg. 2022 Dec;14(12):3277-3282. doi: 10.1111/os.13555. Epub 2022 Oct 21.
The oscillating saw has some inherent disadvantages, such as notch formation and blood splash. The objective is to introduce the Gigli saw as a substitute osteotomy tool when oscillating saw malfunctions occur during surgery.
During our retrospective study, 120 patients (120 hips) who underwent primary total hip arthroplasty (THA) because of femoral neck fracture, femoral head necrosis, developmental hip dysplasia (Crowe I), or primary osteoarthritis between October 2017 and April 2020 at our institute were included. Sixty patients (26 men and 34 women) with a mean age of 67.3 years (±15.1 years) underwent femoral neck osteotomy using a Gigli saw. The other 60 patients (32 men and 28 women) with a mean age of 64.4 years (±18.8 years) underwent femoral neck osteotomy using an oscillating saw. Intraoperative evaluations, including osteotomy time, osteotomy height, number of notch formations, and blood splash generation, were performed. Routine anteroposterior views of the pelvis and proximal femur were obtained for all patients after surgery.
The mean osteotomy times were 26.60 ± 14.80 s and 31.80 ± 14.20 s with the oscillating saw and Gigli saw, respectively (t = 1.964, P = 0.0519). The mean osteotomy heights were 1.26 ± 0.22 cm and 1.20 ± 0.14 cm with the oscillating saw and Gigli saw, respectively (t = 1.782, P = 0.0773). The use of a Gigli saw did not result in bone notch formation or blood splash generation when multiple blood splashes were generated in the oscillating saw group. Postoperative radiographs showed no prostheses malposition in the Gigli saw and oscillating saw groups.
The Gigli saw has various advantages and can be a substitute tool for femoral neck osteotomy during THA when oscillating saw malfunctions occur.
摆动锯具有一些固有缺点，例如形成切迹和溅血。目的是在手术中摆动锯出现故障时引入 Gilgi 锯作为替代截骨工具。
在我们的回顾性研究中，纳入了 2017 年 10 月至 2020 年 4 月期间在我院因股骨颈骨折、股骨头坏死、发育性髋关节发育不良（Crowe I 型）或原发性骨关节炎而接受初次全髋关节置换术（THA）的 120 例患者（120 髋）。60 例患者（26 例男性和 34 例女性），平均年龄 67.3±15.1 岁，采用 Gilgi 锯行股骨颈截骨术。另外 60 例患者（32 例男性和 28 例女性），平均年龄 64.4±18.8 岁，采用摆动锯行股骨颈截骨术。术中评估包括截骨时间、截骨高度、切迹形成数量和溅血生成情况。所有患者术后均常规拍摄骨盆和股骨近端正位片。
摆动锯组的平均截骨时间为 26.60±14.80s，Gilgi 锯组为 31.80±14.20s（t=1.964，P=0.0519）。摆动锯组的平均截骨高度为 1.26±0.22cm，Gilgi 锯组为 1.20±0.14cm（t=1.782，P=0.0773）。当摆动锯组出现多次溅血时，Gilgi 锯不会导致骨切迹形成或溅血生成。术后 X 线片显示 Gilgi 锯和摆动锯组均无假体位置不当。
当摆动锯出现故障时，Gilgi 锯具有多种优势，可作为 THA 中股骨颈截骨的替代工具。
