The examples of TM presented in this article support the argument for the formation of more TM networks on the local and regional levels. Financial constraints for TM can be overcome by pooling government, academic, private, and industry resources in an organized fashion with oversight by a lead TM researcher.

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Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high level heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws. Materials and methods: Many points of view of orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented. Results: Several potential complications are discussed and highlighted that lead to thermal necrosis. Discussion: Even in the face of growing evidence as to the negative effects of heatinduction during drilling, simple and effective methods for monitoring and cooling in realtime are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems, and computer simulation techniques. Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.

The drilling bone may potentially cause excessive frictional heat, which can lead to local bone necrosis. This heat generation and local necrosis has been suggested to contribute to the resorption of bone around the placed screws, ending in loss of screw purchase in the bone and inadvertent loosening and/or the bone‐implant construct. In vivo studies on this subject have inherent obstacles not the least of which is controlling the variables and real time bone temperature data acquisition. Theoretical models can be generated using computer software and the inclusion of known constants for the mechanical properties of metal and bone. These known Data points for the variables (drill bit and bone) enables finite element analysis of various bone drilling scenarios. An elastic–plastic three‐dimensional (3D) acetabular bone mode was developed and finite element model analysis (FEA) was applied to various simulated drilling procedures. The FEA results clearly indicate that the depth of drilling and the drill speed both have a significant effect on the temperature during drilling procedures. The reduction of the feeding speed leads to a reduction in bone temperature. Our data suggests that reducing the feeding speed regardless of RPMs and pressure applied could be a simple useful and effective way to reduce drilling temperatures. This study is the first step in helping any surgeon who drills bone and places screws to better understand the ideal pressure to apply and drill speed to employ and advance rate to avoid osteonecrosis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2386–2391, 2017.

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Background: In North America and three European countries Translational Medicine (TM) funding has taken center stage as the National Institutes of Health (NIH), for example, has come to recognize that delays are common place in completing clinical trials based upon benchside advancements. Recently, there are several illustrative examples whereby the translation of research had untoward outcomes requiring immediate action. Methods: Focus more on three-dimensional (3D) simulation, biomarkers, and Artificial Intelligence may allow orthopaedic surgeons to predict the ideal practices before orthopaedic surgery. Using the best medical imaging techniques may improve the accuracy and precision of tumor resections. Results: This article is directed at the young surgeon scientist and in particular orthopaedic residents and all other junior physicians in training to help them better understand TM and position themselves in career paths and hospital systems that strive for optimal TM. It serves to hasten the movement of knowledge garnered from the benchside and move it quickly to the bedside. Conclusions: Communication is ongoing in a bidirectional format. It is anticipated that more and more medical Centers and institutions will adopt TM models of healthcare delivery.

SimulationFracture complexity O3DC a b s t r a c t Generally, in some universities of medicine, orthopaedic training procedures represent a difficult task due to the inadequacies of the systems, the resources, and the use of technologies. This article explains the challenges and the needs for more research in the issue of orthopaedic simulation around the world.

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