Expert review of medical devices
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The aim of this review is to report on studies of hydroxyapatite-coated external fixation pins as a solution to enhance pin fixation. In a highly loaded animal study, three tapered pin types were compared: Type A uncoated, Type B coated with hydroxyapatite and Type C coated with titanium. There was a 13-fold increase in the extraction torque of Type B pins compared with Type A, and a twofold increase compared with Type C pins. ⋯ Extraction torque of the hydroxyapatite-coated pins was higher than the extraction torque of the standard pins in both cancellous and cortical bone (p < 0.005). In a prospective, randomized clinical study of osteoporotic wrist fractures, extraction torque of the coated pins was higher than with standard pins (p < 0.0001). These studies demonstrate that with the use of hydroxyapatite-coated pins, no deterioration of pin fixation occurs, and that there is no significant pin loosening and infection, regardless of bone type and loading conditions.
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Expert Rev Med Devices · Jul 2005
ReviewComputer-aided surgery of the paranasal sinuses and skull base.
Endoscopic sinus surgery is one of the most common surgical procedures in otolaryngology. However, the location of the orbit and intracranial contents in close proximity to the paranasal sinuses makes endoscopic sinus surgery potentially hazardous. Otolaryngologists have employed computer-aided surgery, or image-guided surgery, over the past two decades to enhance surgeon confidence, allow more thorough surgical dissections and possibly reduce the complication rate of endoscopic sinus surgery. ⋯ A number of institutional series noting surgeon experience with computer-aided surgery in the domain of paranasal sinus surgery are reviewed. Furthermore, the authors evaluate the utility of image-guidance technology beyond the paranasal sinuses and skull base, such as its use in surgery of the pituitary gland and pterygopalatine fossa, research and resident education. Finally, potential future applications of computer-aided surgery technology are discussed.