Curettage of bone is more efficient with a vacuum-assisted bone harvester than with traditional curettes.

BACKGROUND: Bone curettage is an important technique in orthopedic procedures traditionally performed with manual curettes or rongeurs. Vacuum-assisted devices integrate suction with curettage and have the potential to improve efficiency. However, research comparing these devices with traditional methods is limited. This study aimed to evaluate the performance of a vacuum-assisted bone harvester against the manual curette for bone debridement in a simulated model. METHODS: This study compared the Avitus® device with traditional manual curettage using modified femur bone models. A randomized crossover design was employed, where medical trainees performed curettage with both methods. Data were collected on procedure time, frequency of instrument removals, and participants’ subjective ratings of ease of use, perceived effectiveness, and overall preference. RESULTS: A total of 25 participants completed the study. Procedure time was faster with the vacuum-assisted device, with a median time of 113 s (Interquartile range [IQR] = 35) compared to 184 s (IQR = 77) for the traditional method (p = 0.001). The vacuum-assisted device also required fewer instrument removals (6.5 vs. 20.5, p < 0.001). Subjectively, participants rated the vacuum-assisted device as significantly easier to use, with a median ease-of-use score of 4 (IQR = 1) compared to 2 (IQR = 1) for the traditional curette (p < 0.001). Additionally, perceived speed was rated higher for the vacuum-assisted device, with a median score of 4 (IQR = 0) compared to 2 (IQR = 0) for the manual curette (p < 0.001). Despite these advantages, 40% of participants reported challenges, primarily with clogging (28%). DISCUSSION: The vacuum-assisted bone harvester was significantly more efficient and easier to use than the traditional manual curette, with faster procedural times and fewer instrument removals. Although some participants encountered issues like clogging, the device’s overall benefits in terms of procedural speed and ease of use suggest it could improve surgical workflow. Further research in real-world settings and with experienced clinicians is needed to assess its broader applicability.

Duke Scholars

Author William Curtis Eward Orthopaedic Surgery