Advances in Power Tools

These are the key features that will steer your purchasing in the right direction.

If your surgeons rely on older power tools because they’re used to them, it’s time to help them keep pace with the changes that continue to revolutionize the kinds of saw and drills they can have at their disposal. New technological advancements drive new high-performance models with the latest features to the market each year that allow surgeons to maximize their skills and perform with greater efficiency and accuracy in the operating room.

It’s no wonder the global market for orthopedic power tools and consumables is forecasted to grow to $1.6 billion by 2030, according to GlobalData insights. With such a vast market filled with so many options, here are several features to consider when upgrading your power tools.

Weight, balance and ergonomics

These are critical factors in how well tools perform. If tools are too heavy, surgeons tire during lengthy procedures and are unable to apply the right amount of force to drill or cut through bones safely. Many surgeons prefer lightweight options with enough power to get the job done. Lighter materials like metal alloys also have the advantage of generating less heat.

“You need to have surgeon buy-in when getting power tools, and weight is a big issue because they hold the tools for a long time,” says Rob Taylor, RN, BS, IP, clinical director, total joint coordinator and infection preventionist at Constitution Surgery Center East in Waterford, Conn.

Along with weight, proper ergonomics limits fatigue. Power tools should be weight-balanced and include handpieces that provide a comfortable grip. The tool’s shape should also be considered. Gun-shaped tools work best for long-bone surgery or traumatology, while pen-shaped tools are more suitable for microsurgery or smaller bones.

Going cordless

FEEL THE POWER High-speed power makes tools more accurate and easier to use, and torque is essential to overcome friction when digging into a bone.

One recent advancement in orthopedic power tools has been the power source itself. Traditional tools were pneumatic, but the use of such tools has declined as more operating rooms move toward higher-priced electric and battery-powered instruments. The general trend is toward rechargeable lithium or nickel battery-powered tools. One of the top advantages of battery-powered instruments is that they increase a surgeon’s mobility.

“Cordless tools are the biggest change I’ve seen in the past five to 10 years,” says Hui Zhang, MD, an orthopedic surgeon at Aurora Health Center Oak Creek in Wis. “Not too long ago, we used tools with many cords to swap in and out, and they’d be going across the surgical field.”

A downside of battery-powered devices is that they’re limited by the duration of use and charging times. But Dr. Zhang says that while surgeons may sometimes burn through battery life during major reconstructive surgeries, it’s not a big deal during most cases because backup batteries are almost always readily available.

You need to have surgeon buy-in when getting power tools, and weight is a big issue because they hold the tools for a long time.
Rob Taylor, RN, BS, IP

Larger surgical drills and tools used for trauma surgery and knee and hip replacements have had cordless options for a relatively long time, but smaller handheld tools that are cordless are a more recent development. It’s an advancement that Dr. Zhang appreciates as a foot and ankle specialist. “All the newer designs for power tools like cordless are more conducive to getting things done faster,” he says.

Back-up support & less obvious features

BACK-UP SUPPORT Service, repairs and warranties are key considerations when purchasing new power tools.  |  Jennifer Parrott

Some advances in orthopedic power tool technology are more subtle. After trialing three providers, Mr. Taylor’s ASC chose a new power tool and drill vendor. He’s in a busy orthopedic center that runs the gamut on power needs and says its vendor selection came down to how they packaged their power tools.  The sterile processing component and all the tools’ accessories come in a kit, and you can put small bone and big bone power in the same container. “The batteries can be autoclaved, which saves a step and is much more efficient for the OR,” says Mr. Taylor.

Dr. Zhang adds that more minimally invasive surgical tools and techniques are being tried now. With minimally invasive technology, he can use small handheld tools to limit the size of incisions. “The jury’s still out to see if minimally invasive techniques work over the long term and if it’s viable and safe, but it’s promising,” he says. For minimally invasive systems, Dr. Zhang says how they function with irrigation systems and if they could burn skin are key pre-purchase considerations.

Another is back-up support. Service, repairs and warranties are important to take into account when purchasing new power tools. More recent devices shouldn’t need much service, but there’s always wear and tear. As devices age, the availability of parts decreases, so it’s more difficult to get tools serviced in a timely fashion.

“You need to have a good relationship with the vendor and service provider,” says Mr. Taylor. “The service rep can often provide loaner tools when something’s being prepared, which is a big help.” The new power tool vendor his hospital chose is one of the biggest on the market. Picking a larger vendor was important because the bigger companies often provide the best service and fastest repairs, he says.

Speed & torque

Speed — the number of revolutions the drill bit makes or cycles a blade completes in a given time — and torque — the amount of power applied by the tool — are critical elements in the performance of surgical power tools. High-speed power makes tools accurate and easier to use and torque is essential to overcome friction when digging into a bone. Drill speeds of orthopedic power tools vary between 500 and 1500 rpm.

Some vendors use high drill speed as a marketing pitch but don’t get too carried away by that. Clinical research shows high drill speeds can cause burning of the bone area, and the heat generated can result in necrosis of bone cells. The purpose should always be fast patient recovery and not quicker surgery times. Because of this, it’s advised to use new or non-blunt drill bits that increase drilling performance instead of drill speeds that exceed 750 rpm. As for torque, surgical tools should be strong enough to not stop when touching the bone. This means the tools should produce a torque value between a minimum of 15 Nm and a maximum of 20 Nm.

Give surgeons specializing in different orthopedic procedures a chance to test the new tools by conducting vendor trials.Pay close attention to their feedback and concerns. Getting new tools for the best price is essential, but you want to ensure your surgeons are working with tools that will provide the best patient outcomes. They say the tool is only as good as the surgeon who uses it, but with the advancements in new orthopedic power tools, the latest tech can make surgeons better, too. OSM