Bonopty® 14G

Coaxial bone biopsy system

The Bonopty® 14G system for bone biopsies has been a success since it first reached the market. Today, Bonopty® 14G exists in three lengths, all to perfectly match your various needs.

  • Gain access into the bone, even through thick cortical bone
  • Coaxial system facilitates multiple sampling, or treatment of lesions
  • Achieve excellent core samples with few crusch artifacts
  • Successfully sample somewhat sclerotic lesions
  • A variety of lenghts enhance perfect match for every procedure

Product assortment

Bonopty® Penetration Set, 14G

Bonopty Penetration set 14G

Bonopty® Penetration Set, 14G

Penetration Cannula with Stylet (ID 1.8 mm, OD 2.1 mm, Length 6.5/9.5/13 cm)
Drill (Diameter 1.7 mm, Length 9.2/12.2/16 cm)
Depth Gauge

Sterile, single use

Ordering information:
10-1062 Bonopty® Penetration Set 14G, 6.5 cm
10-1072 Bonopty® Penetration Set 14G, 9.5 cm
10-1082 Bonopty® Penetration Set 14G, 13 cm
MOQ 5 units

Bonopty® Biopsy Set, 15G

Bonopty Biopsy Set 15G

Bonopty® Biopsy Set, 15G

Biopsy Cannula with Stylet (ID 1.3 mm, OD 1.7 mm, Length 13/16/19.5 cm)
Ejector Pin, Depth Gauge

Sterile, single use

Ordering information:
10-1063 Bonopty® Biopsy Set 15G, 13 cm
10-1073 Bonopty® Biopsy Set 15G, 16 cm
10-1083 Bonopty® Biopsy Set 15G, 19.5 cm
MOQ 5 units

Bonopty® Extended Drill, 15G

Bonopty Extended Drill 15G

Bonopty® Extended Drill, 15G

Extended Drill (Diameter 1.7 mm, Length 16 cm)

Sterile, single use

Ordering information:
10-1074 Bonopty® Extended Drill 15G, 16 cm
MOQ 5 units

Bonopty® Adapter 1:3 Revolutions

Bonopty Adapter 1:3 Revolutions

Bonopty® Adapter 1:3 Revolutions

Adapter 1:3 Revolutions
Universal connector, fits both 12G and 14G drills

Sterile, single use

Ordering information:
250 Bonopty® Adapter 1:3 Revolutions
MOQ 5 units

Documents

Click reference to view abstract

Thirty-seven consecutive bone biopsies guided with computed tomography were performed in 32 patients by use of three different techniques to penetrate cortical bone and gain access to the lesion. The following instruments were used: a thin bone biopsy needle (12 biopsies), a conventional drill with an outer cannula (six biopsies), and a coaxial biopsy system that consists of a drill with an eccentric tip and an outer cannula (19 biopsies). This eccentric drill makes a hole in the bone larger than the diameter of the cannula and thereby makes it easy to advance the cannula over the drill until the cannula is anchored in the bone. One can then obtain multiple samples through the cannula. The thin bone biopsy needle could not penetrate thick (8 mm thick) cortical bone. The outer cannula was not anchored in the bone when the conventional drill was used. In 16 biopsies, the new coaxial biopsy system penetrated cortical bone with a thickness of 1-8 mm and was anchored there, and lesion samples were obtained through the anchored cannula.

Twenty-eight consecutive CT (n = 23) or ultrasonographically (n = 5) guided biopsy procedures were performed on musculoskeletal lytic lesions covered (n = 13) or not covered (n = 15) with intact bone. Specimens were obtained by means of Biopty techniques (n = 27), i.e. Biopty and Monopty instruments, through different cannulas with normal or shortened needle-throws. Four out of 5 bone penetrations were successful with an Ostycut needle, and all 8 bone penetrations by a coaxial bone biopsy system with an eccentric drill. The eccentric drill makes a hole in the cortical bone larger than the diameter of the outer cannula of this system, making it easy to anchor the cannula and then coaxially insert a Biopty-Gun needle for example. The overall histopathological diagnostic accuracy of the Biopty techniques was 25/27 (92.6%).

PURPOSE: To evaluate the role of CT with and without clinical information as compared to CT-guided bone biopsy in the assessment of suspected bone metastases.
MATERIAL AND METHODS: The study comprised 51 consecutive patients with suspected bone metastases who had undergone CT-guided bone biopsies with an eccentric drill system. CT of the targets, clinical information, and histopathology were scored separately as malignant, uncertain or benign. The results of CT alone and CT in combination with clinical information were compared to the results of histopathology.
RESULTS: Histopathology diagnosed 45/51 lesions (88%), 23 as malignant and 22 as benign. CT correctly depicted 17 of these 23 malignant lesions. The remaining 6 malignant lesions were CT-scored as uncertain (n = 5) or benign (n = 1). CT correctly depicted only 3 of the 22 benign lesions. The remaining 19 benign lesions were CT-scored as malignant (n = 2) or uncertain (n = 17). When uncertain CT scores were combined with clinical scores, the true-positive and true-negative results for malignancy increased from 44% to 82%.
CONCLUSION: In most cases, CT in combination with clinical information gives enough information about the nature-malignant or benign-of a skeletal lesion. In uncertain cases, diagnostic accuracy can be improved by means of CT-guided bone biopsy.

Percutaneous interventional procedures for the musculoskeletal system are demonstrated and explained by means of a hypertext-based teaching file. The authors provide an overview of different procedures including musculoskeletal biopsy, percutaneous periradicular infiltration, diskography, percutaneous cementoplasty, percutaneous treatment of disk herniation, and percutaneous treatment of osteoid osteoma. The procedures are demonstrated with detailed illustration of materials used and computed tomographic and fluoroscopic images. The authors guide the user through each step of the procedures, with case studies that include indications, techniques, complications, and results.

OBJECTIVE: To review our experience with percutaneous radiofrequency ablation (RFA) for osteoid osteoma.
PARTICIPANTS, DESIGN AND SETTING: Retrospective review of 24 patients with osteoid osteoma treated with percutaneous RFA at St Vincent’s Hospital, Melbourne, from August 2000 to February 2005.
MAIN OUTCOME MEASURES: Initial response to treatment, return of symptoms, time to recurrence, complications and histopathological correlation. RESULTS: In 23 of 24 patients, there was immediate relief of symptoms. One-third of patients had a return of symptoms. The 24 patients underwent a total of 32 RFA procedures. Of the eight patients who had a recurrence, five had an initial lesion > or = 10 mm in maximum diameter. Twenty-three of the 24 patients were pain-free at the end of the study period. Patients were followed up for a median of 26 months. There were no long-term complications.
CONCLUSIONS: Percutaneous RFA is a safe and efficacious treatment for osteoid osteoma with a low morbidity rate. Despite recurrence after treatment, re-treatment is simple and effective.

Elsevier’s new Problem Solving in Radiology series offers you a concise, practical, and instructional approach to your most common imaging questions. In the Musculoskeletal Volume, you’ll find expert guidance on how to accurately read what you see and how to perform common office procedures, including arthrography and biopsy. User-friendly features such as numerous tables, boxes, tips, rules of thumb, and an atlas-style appendix put today’s best practices at your fingertips. A full-color design, including more than 700 high-quality images highlight critical elements and compliment the text, to enhance your understanding. Best of all, a bonus CD provides you with musculoskeletal CT, MRI, and ultrasound protocols, patient questionnaires, and an appendix that details how to properly image the hip.

This book is the first book on musculoskeletal injections and interventions written by a team of interventional radiologists. No other book has as many images, all with the highest quality resolution. The concise and user-friendly format gives the busy clinician all the information needed to treat musculoskeletal pain. It covers all major joint interventions for shoulder; hip and pelvis;knee; elbow; wrist and hand; ankle and foot; and soft tissue. Each major entity has full color anatomic illustrations that compliment the hundreds of high quality radiographic images.

OBJECTIVE: To assess whether there are significant differences in ease of use and quality of samples among several bone biopsy needles currently available.
DESIGN: Eight commonly used, commercially available bone biopsy needles of different gauges were evaluated. Each needle was used to obtain five consecutive samples from a lamb lumbar pedicle. Subjective assessment of ease of needle use, ease of sample removal from the needle and sample quality, before and after fixation, was graded on a 5-point scale. The number of attempts necessary to reach a 1 cm depth was recorded. Each biopsy specimen was measured in the gross state and after fixation.
RESULTS: The Radi Bonopty® 15 g and Kendall Monoject J-type 11 g needles were rated the easiest to use, while the Parallax Core-Assure 11 g and the Bard Ostycut 16 g were rated the most difficult. Parallax Core-Assure and Kendall Monoject needles had the highest quality specimen in the gross state; Cook Elson/Ackerman 14 g and Bard Ostycut 16 g needles yielded the lowest. The MD Tech without Trap-Lok 11 g needle had the highest quality core after fixation, while the Bard Ostycut 16 g had the lowest. There was a significant difference in pre-fixation sample length between needles (P<0.0001), despite acquiring all cores to a standard 1 cm depth. Core length and width decrease in size by an average of 28% and 42% after fixation.
CONCLUSION: Bone biopsy needles vary significantly in performance. Detailed knowledge of the strengths and weaknesses of different needles is important to make an appropriate selection for each individual’s practice.

PURPOSE: To report our experience with technical success, complications, and long-term clinical success of radiofrequency (RF) ablation of osteoid osteoma.
MATERIALS AND METHODS: After needle biopsy, computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 90 degrees C for 6 minutes. Patient age and sex, lesion size and location, biopsy results, and complications were recorded. Clinical success was assessed at a minimum of 2 years after the procedure. Significance of patient age and sex and lesion location and size as a predictor of biopsy result was tested by means of chi2 analysis. In addition, effects of patient age and sex, lesion location and size, and biopsy results on clinical success were tested with the Fisher exact test.
RESULTS: During an 11-year period, 263 patients who were suspected of having osteoid osteoma underwent 271 ablation procedures. All procedures were technically successful. There were two anesthesia-related complications (aspiration, cardiac arrest) and two minor procedure-related complications (cellulitis, sympathetic dystrophy). Results at biopsy were positive in 73% (197 of 271 biopsies). Two-year follow-up data were available for 126 procedures. The other procedures had been performed more recently or the patients could not be contacted. There was complete relief of symptoms after 112 of the 126 procedures (89%). For procedures performed as the initial treatment, the success rate was 91% (107 of 117 procedures). Procedures for recurrent lesions had a significantly lower success rate (six of 10 procedures [60%], P <.001). Clinical outcome was not dependent on biopsy result, patient age or sex, or lesion size or location.
CONCLUSION: CT-guided percutaneous RF ablation of osteoid osteoma is a safe and effective technique.

PURPOSE: To evaluate changes in cardiac and respiratory rates in a consecutive series of patients who underwent percutaneous treatment for lesions presumed to be osteoid osteoma in whom general anesthesia was established.
MATERIALS AND METHODS: Changes in cardiac and respiratory rates were evaluated after establishment of stable general anesthesia in 14 patients who underwent needle biopsy and radio-frequency treatment. Cardiac and respiratory rates were recorded at penetration of skin, muscle, periosteum, cortex, and tumor. Treatment was performed before the biopsy report was available.
RESULTS: Biopsy results revealed osteoid osteoma in 10 patients, chondroblastoma in one, and a herniation pit in one. Results in the two remaining patients were nondiagnostic and were excluded. Puncture of skin, muscle, and periosteum caused no detectable change. However, in the 10 patients with biopsy-proved osteoid osteoma, puncture of the tumor caused the mean cardiac rate to increase an average of 26 beats per minute (40%) to 91 (range, 62-114; P <.001) and the mean respiratory rate to increase an average of 12 breaths per minute (50%) to a mean of 37 (range, 25-52; P <.001). These changes occurred within seconds of tumor puncture and were often the first indication to the surgeon that the tumor had been entered. In the two patients with other diagnoses at biopsy, no such change was apparent.
CONCLUSION: Mean cardiac and respiratory rates increase significantly at needle puncture of osteoid osteoma.

Brodie’s abscess is an insidious, localized, subacuteosteomyelitis, typically caused by Staphylococcus aureus.Typically seen in the metaphyses of long bones in a youngmale patient, the diagnosis is frequently challenging. Thereare often mild clinical symptoms and radiographic featuresare frequently similar to primary bone tumours such asosteoid osteoma. Although the imaging features of Brodie’s abscess arewell established, histopathological diagnosis is indicated toestablish a diagnosis and guide treatment. Conventionaltreatment is curettage, biopsy, and culture followed byimmobilization and a prolonged period of antimicrobialtherapy. We describe a case of percutaneous computedtomography (CT) drainage as a novel adjunct in the treatmentof Brodie’s abscess with diagnostic and therapeutic value.

PURPOSE: To retrospectively identify risk factors that may impede a favorable clinical outcome after thermocoagulation for osteoid osteoma.
MATERIALS AND METHODS: Informed consent (permission for the procedure and permission to use patient data for analysis) was obtained from all patients who met study criteria, and institutional review board did not require approval. Analysis included age, sex, size and location of osteoid osteoma, presence of calcified nidus, number of needle positions used for coagulation, coagulation time, accuracy of needle position, learning curve of radiologist, and previous treatment in 95 consecutive patients with osteoid osteoma treated with thermocoagulation. With chi(2) analysis, Fisher exact test, or unpaired Student t test and logistic regression analysis, 23 unsuccessfully treated patients were compared with 72 successfully (pain-free) treated patients.
RESULTS: Parameters associated with decreased risk for treatment failure were advanced age (mean age, 24 years in treatment success group vs 20 years in treatment failure group) and increased number of needle positions during thermocoagulation. Estimated odds ratios were, respectively, 0.93 (95% confidence interval: 0.88, 0.99) and 0.10 (95% confidence interval: 0.02, 0.41). Patients with a lesion of 10 mm or larger seemed at risk for treatment failure (odds ratio = 2.68), but the 95% confidence interval of 0.84 to 8.52 included the 1.00 value. Needle position was inaccurate in nine of 23 patients with treatment failure; only one needle position was used in eight of these nine patients. Lesion location, calcification, sex, coagulation time, radiologist’s learning curve, and previous treatment were not risk factors.
CONCLUSION: Multiple needle positions reduce the risk of treatment failure in all patients and should especially, but not exclusively, be used in large (> or =10-mm) lesions or lesions that are difficult to engage to reduce the risk for unsuccessful treatment.

Osteoid osteoma is a slow-growing tumour with limited growth potential. In the past, treatment comprised open surgery with en-bloc resection or curettage of the tumour. In recent years, various minimally invasive percutaneous treatments have gained popularity. We report on six patients who underwent computed tomography-guided percutaneous radiofrequency ablations of osteoid osteomas between January 2000 and December 2003 in a regional hospital in Hong Kong. Technical success was achieved in all procedures, with a mean follow-up of 40 months (range, 18-65 months). Five of the six patients achieved complete pain relief after the procedure and remained pain-free on subsequent follow-up. One patient with persistent symptoms after the first ablation was successfully treated with a second ablation. The mean in-hospital stay was 2.4 days. Progress in radiological healing was observed in all patients. There was one complication of skin burn over the needle entry site. Our experience shows that percutaneous computed tomography-guided radiofrequency ablation is a minimally invasive and cost-effective treatment for osteoid osteoma.

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