Robotic guided waterjet cutting technique for high tibial dome osteotomy: A pilot study. Issue 3 (12th May 2017)

• Record Type: Journal Article
• Authors: Suero, Eduardo M.; Westphal, Ralph; Zaremba, David; Citak, Musa; Hawi, Nael; Citak, Mustafa; Stuebig, Timo; Krettek, Christian; Liodakis, Emmanouil
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 13:Issue 3(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-05-12
• Subjects: abrasive waterjet -- computer assisted surgery -- dome osteotomy -- knee; Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.1825
• Languages: English
• ISSNs: 1478-5951

Abstract

Abstract: Background: Oscillating saws generate high levels of heat (up to 150°C), which can lead to tissue necrosis, delayed healing and infection. Abrasive waterjet‐cutting techniques have been described as a new tool to perform bone cuts, with less heat generation. Methods: Four lower‐limbs of four human alcohol conserved cadavers were tested. Navigation references were attached to the tibia and an intraoperative fluoroscopy‐based 3D scan was obtained. A 1.2 mm diameter nozzle was attached to a robotic arm, which was guided to follow a pre‐specified path. In addition, a self‐designed jet‐absorber was applied to protect the posterior neurovascular structures. Magnesium was added as an abrasive substance to improve the cutting ability of the waterjet. Results: In all four cadavers, the osteotomies could be carried out as planned, resulting in smooth cut surfaces. No damage to the soft‐tissues was observed. Conclusions: The advantages of abrasive waterjet‐cutting give it great potential in orthopaedic surgery. A current disadvantage is the amount of magnesium solute that is left on the surgical field and can be harmful to the patient.