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Electrical Bioimpedance-Controlled Surgical Instrumentation.

Christian Brendle, Benjamin Rein, Annegret Niesche

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    This study introduces a novel bioimpedance-controlled surgical instrument for bone cement removal during hip replacement surgery. This innovative system enhances safety and precision by minimizing tissue damage compared to traditional methods.

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    Area of Science:

    • Biomedical Engineering
    • Surgical Instrumentation
    • Medical Devices

    Background:

    • Traditional bone cement removal in revision hip replacement uses manual tools like hammers and chisels, posing risks of unintended tissue damage.
    • Current methods lack precision and control, potentially leading to complications during revision total hip replacement procedures.

    Purpose of the Study:

    • To present a novel bioimpedance-controlled surgical instrumentation for precise bone cement milling during revision total hip replacement.
    • To enhance surgical safety and reduce risks associated with manual bone cement removal.

    Main Methods:

    • Utilized electrical bioimpedance measurements for online process control, with the milling head serving as both a cutting tool and electrode.
    • Developed a novel integrated surgical milling tool for acquiring bioimpedance data for real-time control.
    • Employed finite element method simulations and experimental studies with a rapid control prototyping system for process identification.

    Main Results:

    • The bioimpedance-controlled system demonstrated the ability to avoid most risks associated with bone cement removal.
    • Achieved high accuracy (±0.5 mm) through process identification, noise characterization, and filtering techniques.
    • Comparative analysis showed effective noise suppression using moving average and Kalman filters.
    • The system performed effectively even at higher feed rates (5 mm/s).

    Conclusions:

    • Bioimpedance-controlled surgical instrumentation offers a safer and more precise alternative to traditional bone cement removal methods.
    • The developed system enables online process control, significantly improving outcomes in revision total hip replacement.
    • This technology has the potential to revolutionize bone cement management in orthopedic surgery.