Articulating Rotary Burs for Enhanced Bone Resection: Implications for Arthroscopic, Endoscopic Spinal, and Robotic Surgery.

Abstract

IntroductionBone resection in minimally invasive procedures requires precise instrument positioning within constrained joint environments. Conventional straight arthroscopic burs (SABs) offer limited mobility due to geometric and soft tissue restrictions, often necessitating portal adjustments or tissue releases. Articulating rotary burs (ARB) incorporate adjustable articulation angles to enhance mobility and minimize collateral damage. This study aimed to quantitatively evaluate the cutting surface area (CSA) of a SAB and an ARB to compare efficiency in bone resection.MethodsA 3D point cloud analysis was performed in SolidWorks (Dassault Systèmes, Vélizy-Villacoublay, France) to compare CSA of a 5.0 mm SAB and a 5.0 mm ARB (Articulator™ Arthroscopic Bur, Joint Preservation Innovations, Naperville, IL), both with ball bur heads. Analyses accounted for continuous rotation about the tool's long axis. The SAB was compared with the ARB at 0°, 15°, and 30° distal articulation. Surface areas are reported in in² with metric equivalents (mm²). An aggregate motion-envelope CSA (0°-30°) was calculated as the sum of articulated positions.ResultsThe CSA of the SAB was 0.081 in² (52.3 mm²). The ARB CSA was 0.081 in² (52.3 mm²) at 0°, 0.203 in² (131.0 mm²) at 15°, and 0.284 in² (183.2 mm²) at 30°, totaling 0.568 in² (366.5 mm²). Overall, the ARB demonstrated a 601% greater CSA.ConclusionIn this geometric modeling study, distal articulation increased accessible CSA across articulated positions. ARBs may expand geometric access in minimally invasive settings; however, translation to surgical performance (eg, resection rate, thermal effects, torque transmission, and safety) requires empirical validation.