Sagittal Bone Saw With Orbital Blade Motion for Improved Cutting Efficiency

Abstract

Sagittal bone saws are used by orthopedic surgeons for resection of bone; for example in total joint arthroplasty of the hip and knee. In order to prevent damage to surrounding tissue, sagittal saw blades typically oscillate through a small angle, resulting in reduced cutting rates due to short stroke lengths. To improve bone cutting efficiency, sagittal saws oscillate at high speeds, but this creates frictional heating that can harm bone cells. The focus of this research was to design a new sagittal sawing device for improved cutting efficiency. It was hypothesized that the addition of an impulsive thrust force during the cutting stroke would increase cutting rates in cortical bone. A camdriven device was developed and tested in bovine cortical bone. The impulsive thrust force was achieved by creating a component of blade motion perpendicular to the cutting direction, i.e., orbital blade motion. At the start of each cutting stroke, the mechanism drove the saw blade into the surface of the bone, increasing the thrust force with the intention of increasing the depth of cut per tooth. As each cutting stroke was completed, the blade was retracted from the surface for the purpose of clearing bone chips. The design parameters investigated were cutting stroke length, thrust stroke length, and blade oscillation frequency. A threefactor, twolevel design of experiments approach was used to simultaneously test for the effect of design parameters and their interactions on volumetric cutting rate (n = 32). The addition of orbital blade motion to the sagittal saw improved bone cutting rates over traditional oscillatory motion, especially at lower cutting stroke lengths and higher oscillation frequencies (p < 0.05). However, the magnitude of orbital blade motion based on thrust stroke length was limited by a threshold value of approximately 0.10 mm that when exceeded caused the sagittal saw to rebound from the surface of the bone causing erratic cutting conditions. The factor with the greatest positive effect on cutting rate was oscillation frequency. Cutting rates in cortical bone can be improved with the proposed orbital action sagittal saw.