title: Waterjet cutting of periprosthetic interface tissue in loosened hip prostheses: an in vitro feasibility study.
abstract: Waterjet cutting technology is considered a promising technology to be used for minimally invasive removal of interface tissue surrounding aseptically loose hip prostheses. The goal of this study was to investigate the feasibility of waterjet cutting of interface tissue membrane. Waterjets with 0.2 mm and 0.6 mm diameter, a stand-off distance of 5 mm, and a traverse speed of 0.5 mm/s were used to cut interface tissue samples in half. The water flow through the nozzle was controlled by means of a valve. By changing the flow, the resulting waterjet pressure was regulated. Tissue sample thickness and the required waterjet pressures were measured. Mean thickness of the samples tested within the 0.2 mm nozzle group was 2.3 mm (SD 0.7 mm) and within the 0.6 mm nozzle group 2.6 mm (SD 0.9 mm). The required waterjet pressure to cut samples was between 10 and 12 MPa for the 0.2 mm nozzle and between 5 and 10 MPa for the 0.6 mm nozzle. Cutting bone or bone cement requires about 3 times higher waterjet pressure (30-50 MPa, depending on used nozzle diameter) and therefore we consider waterjet cutting as a safe technique to be used for minimally invasive interface tissue removal.
authors.affiliation: Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, P.O. Box 9600, Leiden 2300RC, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands. Electronic address: g.kraaij@lumc.nl.
authors.forename: Gert
authors.initials: G
authors.lastname: Kraaij
authors.affiliation: Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands; Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
authors.forename: Gabrielle J M
authors.initials: GJ
authors.lastname: Tuijthof
authors.affiliation: Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands.
authors.forename: Jenny
authors.initials: J
authors.lastname: Dankelman
authors.affiliation: Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, P.O. Box 9600, Leiden 2300RC, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
authors.affiliation: Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, P.O. Box 9600, Leiden 2300RC, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Valstar
mesh_terms: D005240:Feasibility Studies; D006622:Hip Prosthesis; D006801:Humans; D008566:Membranes / Q000166:cytology / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011312:Pressure; D011475:Prosthesis Failure; D014867:Water
chemical_list: D014867:Water
keywords: Hip prosthesis; Interface membrane; Loosening; Orthopedic surgery; Waterjet cutting