Osteotomes are bone cutting tools commonly reused in orthopedic surgical procedures. Despite undergoing rigorous cleaning, visual inspection, and sterilization procedures between every use, the condition of the cutting blade edge is commonly not qualitatively assessed. Subjective feedback from surgeons suggests a large variation in osteotome cutting-edge sharpness is found during use. This study seeks to investigate the retention of osteotome cutting-edge sharpness by comparing the wear resistance of as-supplied, electroless nickel, and titanium nitride coated osteotomes following a series of bone cutting tests. Changes in edge sharpness were assessed using visual inspection, depth penetration testing that quantified change in the blade sharpness index, and scanning electron microscopy visual analysis. Visual inspection of each osteotome blade edge was then compared to qualitative blade sharpness index measurement. After use, no cutting-edge damage or change in blade sharpness was detected by visual examination of all three osteotomes; however, the as-supplied osteotome demonstrated 50% loss of blade sharpness index compared to 30% and 15% reduction for the electroless nickel and titanium nitride coated osteotomes, respectively. This finding was supported by scanning electron microscopy evaluation that found greater mechanical damage had occurred along the cutting edge of the as-supplied osteotome compared to the two coated with wear resistant materials. The rapid loss of blade sharpness found in the as-supplied osteotome supports the degradation in cutting performance frequently reported by surgeons. The findings from this study demonstrate blade sharpness index better detects cutting-edge wear compared to visual inspection. Results from this pilot study also suggest the coating of osteotomes in hard-wearing biocompatible materials assists in retaining cutting-edge sharpness over multiple uses. Further study using a larger sample size is required to validate these findings.

中文翻译：

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对骨刀硬质表面涂层和尖端降解进行了初步研究。

截骨术是通常在整形外科手术过程中重复使用的骨切割工具。尽管每次使用之间都要进行严格的清洁，目视检查和消毒程序，但通常不会对定刃边缘的状况进行定性评估。外科医生的主观反馈表明，在使用过程中发现了骨凿尖端锐度的巨大差异。本研究旨在通过比较一系列骨切割测试后所提供的化学镀镍和氮化钛涂层截骨的耐磨性，来研究保留骨刀尖端锐度的方法。使用外观检查，量化刀片锐度指数变化的深度渗透测试和扫描电子显微镜外观分析来评估边缘锐度的变化。然后将目视检查每个骨刀刀片边缘与定性刀片清晰度指数测量值进行比较。使用后，通过目视检查所有三个截骨术均未发现尖端损伤或刀片锋利度的变化。但是，提供的骨刀证明刀片的锋利度指数降低了50％，而化学镀镍和氮化钛涂层的截骨刀分别降低了30％和15％。扫描电子显微镜评估支持了这一发现，发现与所提供的两种涂覆有耐磨材料的骨刀相比，沿所提供的骨刀的切削刃发生了更大的机械损伤。在随附的骨凿中发现的刀片锋利度的迅速下降，支持了外科医生经常报告的切削性能下降。这项研究的结果表明，与目视检查相比，刀片的锋利度指数可以更好地检测出尖端磨损。该初步研究的结果还表明，在耐磨的生物相容性材料中截骨的涂层有助于在多次使用中保持最先进的清晰度。需要使用更大样本量进行进一步研究以验证这些发现。