Evaluating bone biopsy quality by technique in an animal model.

Area of Science:

• Orthopedic Surgery
• Pathology
• Biomedical Engineering

Background:

• Powered bone biopsy devices are increasingly used for their convenience.
• However, concerns exist regarding the diagnostic quality of samples obtained with powered techniques.
• Conflicting evidence necessitates a clear comparison of different bone biopsy methods.

Purpose of the Study:

• To evaluate and compare the diagnostic adequacy of manual, pulsed powered, and full powered bone biopsy techniques.
• To assess the frequency of sample artifacts associated with each bone biopsy method.
• To determine which bone biopsy technique yields the most diagnostically acceptable samples.

Main Methods:

• Lamb femora were biopsied using manual, pulsed powered, and full powered techniques.
• Samples were assessed by blinded pathologists for length, bone dust, thermal/crush artifact, cellular morphology, and fragmentation.
• Bayesian Multilevel Nonlinear Regression models were used for statistical analysis.

Main Results:

• The manual bone biopsy technique significantly outperformed powered techniques across all evaluated categories.
• Manual methods resulted in decreased thermal/crush artifact, bone dust, and fragmentation.
• Samples from manual biopsies demonstrated better cellular morphology and diagnostic acceptability.

Conclusions:

• Manual bone biopsy techniques generally produce more diagnostically adequate samples than powered techniques.
• These findings suggest favoring manual methods when feasible, considering lesion characteristics and patient factors.
• Further consideration of manual bone biopsy is recommended for optimal sample quality.