Ultrasonic technology in revision joint arthroplasty

The development of ultrasonically driven tools for revision joint arthroplasty is presented. The data represent seven-years' experience and include information from laboratory investigation and clinical experience from 20 surgical cases. Whole bone torsional strength studies reveal no decrease in strength parameters after the removal of cement ultrasonically. Comparison studies demonstrate that ultrasonic tools allow more rapid completion of cement and prosthesis removal than traditional manual tools. Histologic studies using an in vivo canine model demonstrate no deleterious effects to endosteal bone where cement had been removed by ultrasound. Clinical studies indicate that the use of ultrasound facilitates the surgery and causes no cortical perforations; the creation of cortical windows was not necessary in all cases. Ultrasound is safe and efficacious in cement and prosthesis removal during revision surgery.