Design and Evaluation of a Surgeon- and CSD-Friendly Bone Rongeur

Over 100 000 orthopaedic surgeries where performed in the Netherlands in 2023. Many boneremoval instruments used in these procedures require high grip strength and large hands, causing issues for a significant number of surgeons. Additionally, the instruments are often difficult to clean. This thesis presents a new bone rongeur usable single-handedly by 60-year-old female surgeons with low hand size and grip strength, while meeting CSD (Central Sterilisation Department) standards. The design draws inspiration from a ratchet-based rongeur developed by van Gorkum et al. with a demonstrated high mechanical advantage. Using this design as inspiration, a new rongeur was designed from the ground up, with cleanability integrated as a key requirement from the start. Requirements were derived and several ideas explored; a ratchet mechanism was selected and developed further. A new type of rotational joint was designed, providing at least 1 mm clearance to enable effective cleaning. Experiments showed a stainless steel prototype achieved a mechanical advantage of ∼ 12 with a handle span of 40 – 92 mm, both appropriate for the intended user group. An interview with a CSD expert confirmed the design’s good cleanability.