Uporaba tehnologije mlaza vode u ortopedskoj kirurgiji (original) (raw)
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Water Jet Technology Using in Orthopaedic Surgery
Subject review The paper deals with potential uses of water jet technology and its modification for cutting of bone tissue and bio-materials. It summarises the present state of the art, defines problems from the technological and surgical point of view in order to increase the quality of treated clients. The paper represents an overview and the first step towards using water jet technique in orthopaedic surgery, during dissintegration of interface between bone and femoral stem.
Water jet technology using at orthopaedic surgery
Tehnicki Vjesnik, 2013
Subject review The paper deals with potential uses of water jet technology and its modification for cutting of bone tissue and bio-materials. It summarises the present state of the art, defines problems from the technological and surgical point of view in order to increase the quality of treated clients. The paper represents an overview and the first step towards using water jet technique in orthopaedic surgery, during dissintegration of interface between bone and femoral stem.
Mechanical Sciences, 2014
Using water jets in orthopedic surgery to drill holes in bones can be beneficial due to the absence of thermal damage and the always sharp cut. To minimize operating time and the volume of water that is used, the efficiency (volume of removed bone per added volume of water) of the water jet should be maximized. The goal was to study the effect of the open trabecular bone structure on the efficiency for different water jet diameters. 86 holes were drilled in porcine tali and femora submerged in water with nozzles of 0.3, 0.4, 0.5 and 0.6 mm at 70 MPa during 5 s and a standoff distance of 8 mm. MicroCT scans were made to measure the removed bone volume and the bone structural properties Trabecular Spacing (Tb.Sp.), Trabecular Thickness (Tb.Sp.) and Bone Volume Fraction (BV/TV). Pearson's correlation tests (p < 0.05, 95 % confidence interval) were performed for each water jet diameter using the bone structural property as an independent factor and the efficiency as a dependent factor. No significant differences were found between the nozzle diameters in the material removal rates per added volume of water. The efficiency decreased for an increase in Tb.Th. and BV/TV for nozzles of 0.3, 0.4 and 0.5 mm. The 0.6 mm nozzle showed less influence of the Tb.Th. and BV/TV. The Tb.Sp. has no influence on the efficiency of a water jet.
Colliding jets provide depth control for water jetting in bone tissue
Journal of The Mechanical Behavior of Biomedical Materials, 2017
In orthopaedic surgery, water jet drilling provides several advantages over classic drilling with rigid drilling bits, such as the always sharp cut, absence of thermal damage and increased manoeuvrability. Previous research showed that the heterogeneity of bone tissue can cause variation in drilling depth whilst water jet drilling. To improve control over the drilling depth, a new method is tested consisting of two water jets that collide directly below the bone surface. The expected working principle is that after collision the jets will disintegrate, with the result of eliminating the destructive power of the coherent jets and leaving the bone tissue underneath the focal point intact. To assess the working principle of colliding water jets (CWJ), the influence of inhomogeneity of the bone tissue on the variation of the drilling depth and the impact of jet time (t wj) on the drilling depth were compared to a single water jet (SWJ) with a similar power. 98 holes were drilled in 14 submerged porcine tali with two conditions CWJ (impact angle of 30°and 90°) and SWJ. The water pressure was 70 MPa for all conditions. The water jet diameter was 0.3 mm for CWJ and 0.4 mm for SWJ. t wj was set at 1, 3, 5 and 8 s. Drilling depth and hole diameter were measured using microCT scans. A non-parametric Levene's test was performed to assess a significant difference in variance between conditions SWJ and CWJ. A regression analysis was used to determine differences in influence of t wj on the drilling depth. Hole diameter differences were assessed using a one way Anova. A significance level of p < 0.05 was set. Condition CWJ significantly decreases the drilling depth variance caused by the heterogeneity of the bone when compared to SWJ. The mean depth for CWJ was 0.9 mm (SD 0.3 mm) versus 4.8 mm (SD 2.0) for SWJ. t wj affects the drilling depth less for condition CWJ (p < 0.01, R 2 =0.30) than for SWJ (p < 0.01, R 2 =0.46). The impact angle (30°or 90°) of the CWJ does not influence the drilling depth nor the variation in depth. The diameters of the resulting holes in the direction of the jets is significantly larger for CWJ at 90°than for 30°or a single jet. This study shows that CWJ provides accurate depth control when water jet drilling in an inhomogeneous material such as bone. The maximum variance measured by using the 95% confidence interval is 0.6 mm opposed to 5.4 mm for SWJ. This variance is smaller than the accuracy required for bone debridement treatments (2-4 mm deep) or drilling pilot holes. This confirms that the use of CWJ is an inherently safe method that can be used to accurately drill in bones. products are primarily used to treat soft tissue (Basting et al., 2000; Oertel et al., 2003; Rau et al., 2008). Recent developments do show that water jet technology can provide similar advantages for cutting or drilling through bone tissue (den Dunnen et al., 2013a, 2013c; Honl et al., 2000; Kuhlmann et al., 2005). This study focusses on water jet drilling for orthopaedic treatments such as drilling pilot holes for screw fixations and bone debridement treatments (Bronzino, 2000; Steadman et al., 2001, 2003). A challenge for orthopaedic water jet surgery lies in controlling the
Applying Waterjet Technology in Surgical Procedures
Acta Scientific Dental Scienecs
The main objective of the paper is to predict the optimal waterjet pressure required to cut, drill or debride the skin layers without causing any damages to the organs. A relationship between the waterjet pressure and skin thickness has been established. It also includes the modulus of elasticity of the skin, the diameter of nozzle orifice, the nozzle standoff distance and the traverse speed of the waterjet as well as the duration of applying the waterjet pressure. Thus, practical relationship between waterjet operating parameters and the physical properties of the skin has been formulated. A real Caesarean section procedure data has been applied to the formulation. Given the Ultimate Tensile Strength of the skin at the abdomen to be 20 MPa, incision parameters of 18 mm deep, 12 cm long and 0.4 mm wide, applying a traverse speed of 0.5 mm/s and stand-off distance of 5 mm, the resulted waterjet pressure is 17.89 MPa using a 0.4 mm orifice diameter. water starts flowing radially and the impact of the jet decreases [4].
Tehnologija vodenog mlaza koja se koristi u medicini
2010
Abrasive water jet technology has been recently used mainly in industrial areas. This technology provides several advantages in comparison with conventional methods. At present, it is used in medicine. This paper discusses the possibility of using water jet technology in medicine. The paper describes the benefits and usage in orthopedic surgery, plastic surgery, neurosurgery, dermatology, urology, and in dental surgery.
Pure Waterjet Drilling of Articular Bone: An in vitro Feasibility Study
Strojniški vestnik – Journal of Mechanical Engineering, 2013
The clinical application of waterjet technology for machining tough human tissues, such as articular bone, has advantages, as it produces clean sharp cuts without tissue heating. Additionally, water supply is possible via flexible tubing, which enables minimally invasive surgical access. This pilot study investigates whether drilling bony tissue with pure waterjets is feasible. Water pressures between 20 and 120 MPa with an orifice of 0.6 mm were used to create waterjets to drill blind borings in the talar articular surface of cadaveric calcaneus bones of humans, sheep, goats and pigs. A stand-off distance between 2.5 and 5.5 mm and a jettime of 5 seconds were chosen. The depth of the holes was measured using a custom-adapted dial gauge. At least 30 MPa of water pressure is required to penetrate the human and goat specimens, and 50 MPa for the pig and sheep specimens. Overall, the machined holes were conically shaped and increased in depth with an increase of pressure. Above certain pressure levels, pure waterjets can be used for machining holes in articular bone, thereby opening a window for further research on pure waterjet drilling in orthopedics.
Investigation of cutting quality and surface roughness in abrasive water jet machining of bone
Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 2018
The abrasive water jet machining is known as a cold cutting process and can be effective for developing cut in the bone in orthopedic surgery to prevent thermal necrosis. This research examined surface roughness and cutting quality of bovine femur bone using abrasive water jet machining. Furthermore, the effect of three parameters was studied including water pressure, traverse speed, and the type of abrasive particles. The feed rate of the abrasive particles was considered 100 g/min, and the levels obtained from pure water jet cutting, bone powder abrasive water jet machining, and sugar abrasive water jet machining were compared with each other. Application of bone powder as an abrasive particle caused improved cutting quality, when compared with pure water jet, and in the best case, it resulted R and R values of 7.36 and 54.76 μm, respectively at the pressure of 3500 bar and traverse speed of 50 mm/min. The minimum surface roughness was obtained using sugar abrasive particles at th...
Disintegration of Bone Cement by Continuous and Pulsating Water Jet
Original scientific paper The paper deals with the study of using continuous water jet and ultrasonic pulsating water jet for bone cement disintegration. Bone-cement Pallacos R+G (manually mixed) was disintegrated ex-vivo. Mechanical properties of the bone cement were determined by nano-indentation. Factors employed in evaluation were pressure (40, 80, 120) MPa and traverse speed for continuous water jet, pressure (8, 10, 12, 14, 16, 20) MPa and orifice type (flat, circular) for ultrasonic pulsating water jet. Depth penetration h (mm) was measured by non-contact optical profilometer MicroProf FRT. Results represent the first step towards feasibility of using effective water jet technique during reimplantation of cemented endoprosthesis, for bone cement removal from femoral canal without heat and mechanical damage of surrounding tissue.
Dissintegration of bone cement by continual and pulsating water jet
Tehnicki Vjesnik
The paper deals with the study of using continuous water jet and ultrasonic pulsating water jet for bone cement disintegration. Bone-cement Pallacos R+G (manually mixed) was disintegrated ex-vivo. Mechanical properties of the bone cement were determined by nano-indentation. Factors employed in evaluation were pressure (40, 80, 120) MPa and traverse speed for continuous water jet, pressure (8, 10, 12, 14, 16, 20) MPa and orifice type (flat, circular) for ultrasonic pulsating water jet. Depth penetration h (mm) was measured by non-contact optical profilometer MicroProf FRT. Results represent the first step towards feasibility of using effective water jet technique during reimplantation of cemented endoprosthesis, for bone cement removal from femoral canal without heat and mechanical damage of surrounding tissue.