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NICE

National Institute for Health and Care Excellence

Medtech innovation briefing [MIB13]

The OSCAR 3 Ultrasonic arthroplasty revision instrument for removing bone cement during prosthetic joint revision

Scanning electron microscopy investigation of PMMA removal by laser irradiation (Er: YAG) in comparison with an ultrasonic system and curettage in hip joint revision arthroplasty

Birnbaum, K. and Gutknecht, N., 2010.
Lasers in medical science, 25(4), pp.595-603.

Safe Removal of Massive Intrapelvic Cement Using Ultrasonic Instruments

Smith, P.N. and Eyres, K.S., 1999.
The Journal of arthroplasty, 14(2), pp.235-238.

Ultrasonically driven instruments in the transfemoral approach–an aid to preservation of bone stock and reduction of implant length

Fletcher, M., Jennings, G.J. and Warren, P.J., 2000.
Archives of orthopaedic and trauma surgery, 120(10), pp.559-561.

Thermal Tissue Damage Caused by Ultrasonic Cement Removal from the Humerus

Goldberg, S.H., Cohen, M.S., Young, M. and Bradnock, B., 2005.
JBJS, 87(3), pp.583-591.

Gas chromatography-mass spectroscopy analysis of emissions from cement when using ultrasonically driven tools

Shewale, S.B. and Briggs, R.D., 2005.
Acta orthopaedica, 76(5), pp.647-650.



Product

GENERATOR

Portable mains generator with microprocessor, power control unit and multiple output channels.

HANDSET

Piezo-ceramic transducers produce ultrasonic energy at a resonant frequency capable of changing the physical properties of bone cement or cutting bone.

SU PROBES

Diverse selection of pre-packed sterile Single-Use probes, which act as waveguides to deliver ultrasonic energy enabling users to cut and remove bone and acrylic bone cement during hip, knee, elbow, shoulder and ankle revision arthroplasty

Services

Enabling access to ultrasonic technology

Supporting your organization’s financial and operational strategy

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PURCHASE
 


Configure your OSCAR System to meet the needs of your clinicians and purchase outright
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LEASE
 


Operating and Capital lease options to spread the cost of owning an entire OSCAR System
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LOAN
 


Hire complete OSCAR Systems as your clinical need demands dictate
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SERVICING
AND WARRANTY


Extensive annual protective maintenance programs to ad-hoc servicing, ensuring that your OSCAR system is fully functional

Applications

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FEMUR


  • Cement removal from the femoral canal
  • Removal of the cement plug
  • Removal of osseointegrated uncemented femoral components
Cemented hip revision, cement removal.
Read more >
Aid of uncemented prosthesis removal.
Read more >
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HIP


  • Cement removal from the acetabulum
  • Removal of osseointegrated uncemented acetabular cups

Cemented hip revision, cement removal.
Read more >
Aid of uncemented prosthesis removal.
Read more >
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KNEE


  • Tibial and femoral prosthesis extraction, either cemented or osseointegrated in situ


Cemented Knee revision, cement removal.
Read more >
Aid of uncemented prosthesis removal.
Read more >
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HUMERUS


  • Cement removal from the thinner cortices and narrower medullae of the Humerus

Cemented Shoulder revision, cement removal.
Read more >
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ELBOW


  • Cement removal from the thinner cortices and narrower medullae of the Ulna

Cemented Elbow revision, cement removal.
Read more >

Support

History

The first generation of OSCAR (OSCAR 1) was launch in 1995 in the UK followed by the USA in 1997. Steady development the OSCAR saw 2nd and 3rd generations brought to market in 2002 and 2010 respectively.

Orthofix has been involved with the OSCAR portfolio since 1993, when it acquired the original company- Orthosonics- and the revolutionary technology.

Orthofix is the proud manufacturer of OSCAR and includes it into its diversified portfolio focused on improving patients' lives by providing superior reconstruction and regenerative musculoskeletal solutions to physicians worldwide. The OSCAR portfolio is now widely distributed via Orthofix sales representatives, distributors and subsidiaries.

Ultrasonic Revision
Arthroplasty System

Frequently Asked Questions

Click on one of the questions to expand text

Probe Stuck in Cement

This is most likely to occur when a piercer is being used. If the tip of the piercer is pushed too deeply into the cement and allowed to remain in situ, then the cement behind the tip is liable to solidify and trap the probe. If this happens, the load on the probe may be excessive preventing normal resonance because of the mass of cement now attached to the probe. If this occurs the generator will automatically enter a ‘stuck in cement’ mode and display CEMENT RELEASE MODE Energise the handset, but do not apply any pressure on the handset for the first 2 seconds of use ( this gives the channel a better chance to find a resonant feature ). The generator will perform repeated scans of the handset, sounding a double beep as it does so. Whilst this occurs, gently remove the probe from the cement. When free from cement the channel mode will return to normal operation. If the display shows WAIT - REDUCE PRESSURE just wait for 4 seconds and the module will reset automatically. Again, energise handset but apply little pressure on the handset for the first two seconds of use, then slowly remove probe.

This procedure may lead to an OVER-TEMPERATURE message on the LCD. Allow the channel to cool for several minutes. When the channel resets attempt removal again. This process may take a couple of attempts, depending how deep the probe is stuck in the cement.

Metal Fatigue

This can occur if the probe comes into contact with metal and becomes scratched, causing a stress riser to appear. When this happens, fragments of the probe are at risk of coming off during operation.

Solution: Change the probe and replace at the earliest opportunity.



Intermittent Power During Operation

If the handset/probe suffers from intermittent power and a clicking noise, caused by the tripping of relays, coming from the generator, then the cable connecting the handset to the generator will have fractured.

Solution: Change the cable associated with the defective system.

Low Power During Operation

i. The probe will appear to be working inefficiently if it is pressed too hard into the cement. The generator will alert the surgeon by sounding an alarm.

Solution: Ease of pressure to enable the probe to work at maximum efficiency always press the tip gently into the cement and use gentle force:- allow the ultrasound to do the work. Avoid excessive force at all times.

ii. Lack of power during cutting can be due to the interface between the probe and the handset being slack.

Solution: Tighten the connection using the 9mm spanner provided. The power level can also be diminished if this interface is not clean and has been damaged due to the presence of particles. Should this occur, it is necessary to re surface the interface, which can be done by Orthofix Srl.
Should the stud attached to the probe become loose, it must be returned to Orthofix Srl for repair.

iii. Loss of power when cutting cement can also be due to the crystals in the handset overheating. The crystals will heat up naturally during normal use, but if excessive force is used for prolonged periods of time this heating will affect performance. As the handset warms up its resonant frequency will drop. If the handset becomes too warm the frequency will drop out of the handsets’ working range and the channel will shut down. The LCD will display FREQUENCY TOO LOW

Solution: Use another handset and allow the hot handset to cool down. The channel will reset automatically when the handset is cool.