Summary
The excimer laser was thought to be an appropriate tool for the removal of bone cement without damaging the bone. However, due to its low ablation rate, its clinical use in total hip revision arthroplasty proved to be impossible. This experimental study was designed to evaluate the maximal ablation rate by adjusting the laser's parameters. Energy density, frequency, pulse duration, radiation area, quantity of pulses, and environmental conditions were varied in the experimental setup. Even with the best set of parameters the excimer laser was about ten times slower than, e.g., the carbon dioxide laser. The removal of 10 g bone cement takes about 1 h. Thus, complete cement removal by means of the excimer laser alone is not possible. However, selective application of the excimer laser in combination with other techniques could be discussed.
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References
Aldinger G (1987) Der Lockerungsvorgang der Hüftendoprothese unter besonderer Berücksichtigung des Zementes. Aktuel Probl Chir Orthop 31:337–341
Buchholz HW (1990) Die Reimplantation von totalen Hüftendoprothesen mit Knochenzement In: Ascherl R, Lechner F, Siebels W, Tensi HM, Blümel E (eds) Die gelockerte Hüt-prothese. Schattauer, Stuttgart, pp 221–235
Choy DSJ, Kaminow JP, Kaplan M, Case RB, Zickel R (1987) Experimental Nd: YAG laser disintegration of methylmethacrylate. Clin Orthop 215:287–288
Daum WJ (1988) Removal of the acetabula component minimizing destruction of the bone bed. J Arthroplasty 3:379–380
Kozinn SC (1989) Simpilified extraction of broken femoral stems. J Arthroplasty 4:183–185
Inglis R, Hermanni A, Windolf J, Pannike A (1990) Schonende PMMA-Entfernung aus dem Femur mit dem C02-Laser. Studie fur Heraeus Instruments GmbH, Hanau, Germany
Ritter MA, Campbell ED (1989) The survival of the cemented femoral component of a total hip replacement. Clin Orthop 243:143–147
Smith JP, Topmiller JL, Shulman S (1990) Factors affecting emission collection by surgical smoke evacuators. Laser Surg Med 10:224–233
Srinivasan R (1986) Ablation of polymers and biological tissue by ultraviolet lasers. Science 234:559–565
Srinivasan R, Braren B, Seeger DE, Dreyfus RW (1986) Photochemical cleavage of a polymeric solid: details of the ultraviolet laser ablation of poly(methyl methacrylate) at 193 and 248 run. Macromolecules 19:916–921
Stühmer KG (1987) Zur Technik der Zemententfernung bei Austauschoperationen von Gelenkprothesen. Aktuel Probl Chir Orthop 31:342–346
Weber U, Nietert M, Jacob E (1987) Möglichkeit und Grenzen der Ultraschallbearbeitung — Entfernung von Knochenzementen. Aktuel Probl Chir Orthop 31:347–349
Weinstein JN, Oster DM, Park JB, Park SH, Löning S (1988) The effect of the extracorporeal shock wave lithotriptor on the bone-cement interface in dogs. Clin Orthop 235:261–267
Zimmer M, Bise K, Fritsch K, Koort HJ, Refior HJ, Seis U, Tack C (1991) Orthopädische Anwendungsmöglichkeiten des Excimer Lasers. In: Siebert W, Wirth CJ (eds) Laser in der Orthopädie. Thieme, Stuttgart New York, pp 42–45
Zimmer M, Bise K, Hohla B, Rückle B, Refior HJ, Seiband K (1991) Experimentelle Ergebnisse zur Gewebefluoreszenz bei Bestrahlung mit dem Xenochlorid-Laser. In: Siebert W, Wirth CJ (eds) Laser in der Orthopädie. Thieme, Stuttgart New York, pp 126–128
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Zimmer, M., Klöbl, R., De Toma, G. et al. Bone-cement removal with the excimer laser in revision arthroplasty. Arch Orthop Trauma Surg 112, 15–17 (1992). https://doi.org/10.1007/BF00431037
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DOI: https://doi.org/10.1007/BF00431037