Basic ScienceElectrocautery Induced Damage of Total Knee Implants
Section snippets
Survey on Electrocautery Use During Total Knee Arthroplasty
To better understand if surgeons use EC after implants are placed during primary TKA and THA, a survey was taken of Hip and Knee Society surgeons. The survey was solicited through an email list, and a request with a Survey Monkey link was sent out to members of The Hip and Knee Society. After 102 replies through Survey Monkey were obtained the survey was closed and the results tabulated. Specifically, the survey asked whether surgeons use EC near the primary implants after they have been
Survey
Results from the survey questions from 102 respondents are shown in Figure 3A-C. When responding to “Do you use electrocautery after the implants are inserted,” 44% responded sometimes and 34% responded always. When asked the same question concerning revision surgery, 31% responded sometimes and 7% always. When asked if the surgeon was aware if the EC could damage the surface of the implant, 49% responded no.
Electrocautery-Damaged Specimens
Visual assessment showed a darkened area for the MP damage of the CoCr and ZrN but the
Discussion
This study determined that there may be a large percentage of surgeons who may not realize the damage that can occur to implant bearing surfaces with local use of EC devices. The use of a BP (Aquamantys) vs an MP (Bovie) in this in vitro study found that the BP imparted less damage on all 3 surfaces by topography measures as well as subjective comparisons. The ZrN was damaged the least amount of the 3 surfaces, as determined by Rz and Ra values, while the Oxinium bearing surface saw the largest
Conclusion
The fact that many expert surgeons surveyed were not aware of the damage that can occur when EC devices are used emphasizes the need for these kinds of studies to be reported. Surface topographies, examined by measuring Ra, Rz, Rsk, and Rk roughness parameters for EC-damaged groups from both MP and BP sources on all 3 surfaces, revealed significant changes that may affect both wear patterns and metal ion release over the lifetime of the implant. The authors do stress that these reported
References (19)
- et al.
Patient satisfaction after total knee arthroplasty: a realistic or imaginary goal?
Orthop Clin North Am
(2017) - et al.
Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants
Pain
(2011) - et al.
Why are total knee arthroplasties failing today—has anything changed after 10 years?
J Arthroplasty
(2014 Sep 1) - et al.
Electrosurgery induced damage to Ti-6Al-4V and CoCrMo alloy surfaces in orthopedic implants in vivo and in vitro
J Arthroplasty
(2017) - et al.
Electrosurgery Surg (Oxford)
(2011) - et al.
Corrosion damage and wear mechanisms in long-term retrieved CoCr femoral components for total knee arthroplasty
J Arthroplasty
(2016) - et al.
Surface roughness of the proximal and distal bearing surface of mobile bearing total knee prostheses
The J Arthroplasty
(2002) - et al.
What is the incidence of cobalt-chromium damage modes on the bearing surface of contemporary femoral component designs for total knee arthroplasty?
J Arthroplasty
(2018) - et al.
What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients
BMJ Open
(2012)
Cited by (0)
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.09.044.