Print Email Facebook Twitter Feasibility study to determine if microfracture surgery using water jet drilling is potentially safe for Talar chondral defects in a Caprine model Title Feasibility study to determine if microfracture surgery using water jet drilling is potentially safe for Talar chondral defects in a Caprine model Author Kok, Aimee C. (Amsterdam UMC) den Dunnen, S. (TU Delft Medical Instruments & Bio-Inspired Technology) Lambers, Kaj T.A. (Amsterdam UMC) Kerkhoffs, Gino M.M.J. (Amsterdam UMC) Tuijthof, G.J.M. (TU Delft Medical Instruments & Bio-Inspired Technology; Amsterdam UMC) Date 2019 Abstract Objective: Surgical microfracture is considered a first-line treatment for talar osteochondral defects. However, current rigid awls and drills limit access to all locations in human joints and increase risk of heat necrosis of bone. Using a flexible water jet instrument to drill holes can improve the reachability of the defect without inducing thermal damage. The aim of this feasibility study is to determine whether water jet drilling is potentially safe compared with conventional microfracture awls by studying side effects and perioperative complications, as well as the quality of cartilage repair tissue. Design: Talar chondral defects with 6-mm diameter were created bilaterally in 6 goats (12 samples). One defect in each goat was treated with microfracture created with conventional awls, the contralateral defect was treated with holes created with 5-second water jet bursts at a pressure of 50 MPa. Postoperative complications were recorded and after 24 weeks analyses were performed using the ICRS (International Cartilage Repair Society) macroscopic score and modified O’Driscoll histological score. Results: Several practical issues using the water jet in the operating theatre were noted. Water jet drilling resulted in fibrocartilage repair tissue similar to the repair tissue from conventional awls. Conclusions: These results suggest that water jet drilling gives adequate fibrocartilage repair tissue. Furthermore, the results highlight essential prerequisites for safe application of surgical water jet drilling: stable water pressure, water jet beam coherence, stable positioning of the nozzle head when jetting, and minimizing excessive fluid extravasation. Subject animal modelsanklecartilage repairgeneraljoint involvedmicrofractureproceduresrepair To reference this document use: http://resolver.tudelft.nl/uuid:91b91a61-23c6-4c6a-ad85-cd4373115dbb DOI https://doi.org/10.1177/1947603519880332 ISSN 1947-6035 Source Cartilage, 13 (2), 1627S-1636S Part of collection Institutional Repository Document type journal article Rights © 2019 Aimee C. Kok, S. den Dunnen, Kaj T.A. Lambers, Gino M.M.J. Kerkhoffs, G.J.M. Tuijthof Files PDF 1947603519880332.pdf 1.27 MB Close viewer /islandora/object/uuid:91b91a61-23c6-4c6a-ad85-cd4373115dbb/datastream/OBJ/view