Assessment of Reprocessed Arthroscopic Shaver Blades

Abstract

The purpose of this study was to evaluate the level of contaminants on, as well as the quality of, reprocessed shaver blades. We assessed 7 new shaver blades and 27 shaver blades that had been reprocessed with mechanical cleaning, functional testing, and sterilization with ethylene oxide. A spectrophotometer measured the amount of nucleic acid and protein. The blade quality was assessed by photographing the blades with magnification and determining the percentage of damage present on each blade. A subset of shaver blades were then used to cut meniscal tissue, and the cut surface was measured for smoothness by image processing and automated laser scanning cytometry. In evaluation of the meniscus, for the subset of shavers, an image processing value of 1 indicates a smooth, straight line, and values lower than 1 reflect deviations in the cut surface (the closer the value is to 1, the smoother the surface). Laser scanning cytometry values indicate the percentage of irregularities in the cut surface (the lower the value is, the smoother the surface). Of the 27 reprocessed shaver blades, 13 (48%) had detectable levels of protein and 17 (63%) had detectable levels of nucleic acid. On the reprocessed shaver blades, protein levels ranged from 2.43 microg to 60 microg and nucleic acid levels ranged from 0.40 microg to 3.5 microg. No new shaver blade had contaminants. Twenty reprocessed shaver blades had been manufactured with teeth and could be evaluated for visible damage. Of these, 10 had 1% to 25% damage, 5 had 26% to 50% damage, 3 had 51% to 75% damage, and 2 had 76% to 100% damage. The new blades had no visible damage. Image processing revealed smoothness of the surface cut with new shaver blades, yielding values of 1 +/- 0.12, whereas the values for reprocessed shaver blades ranged from 0.62 +/- 0.02 to 1 +/- 0.07. Laser scanning cytometry values ranged from 3.3% to 7.1% for the new blades as compared with 5.8% to 20.0% for the reprocessed blades. Of the reprocessed shaver blades, 48% had detectable levels of protein and 63% had detectable levels of nucleic acid. All of the reprocessed blades visually evaluated showed some level of damage or wear, whereas no new blade had such damage. In addition, menisci cut with reprocessed shavers showed rougher edges than did menisci cut with new shavers. To make an informed decision regarding the use of reprocessed shaver blades, surgeons will want to know the level of contamination on, and the quality of, reprocessed shaver blades.