Thermal osteonecrosis of bone in drilling procedure is caused by improper parameters which can lead to poor bone-implant integration and loss of fixation. In this study, Taguchi technique for parameter optimization and multiple regression models for temperature prediction were employed. The main aim of the study was to determine the optimal parameters of bone drilling to control the temperature rise below the thermal osteonecrosis threshold (47[Formula: see text]C) in respect of the bone density variations at different drilling directions. A 32 full factorial design with nine sets of parameters was used in the study. Drilling operations were performed along the longitudinal, radial and circumferential directions at the proximal-diaphysis, mid-diaphysis and distal-diaphysis regions of the 10 adult cadaveric femurs with different feed rates (40, 60 and 80[Formula: see text]mm/min) and spindle speeds (500, 1000 and 1500[Formula: see text]rpm) using 3.2[Formula: see text]mm diameter surgical drill bit. The in-situ drilling temperatures were measured with T-type thermocouple. The optimum drilling parameters for each drilling direction were determined from signal to noise ratios and the effect of each parameter was determined using analysis of variance. By using computed tomography scan data of patients, the proposed method is able to predict the temperature rise at the bone-drilling sites, optimal parameters and possibility for the occurrence of thermal osteonecrosis. This important tool could assist in reducing localized temperature induced from surgical drilling by up to 32% and 18[Formula: see text]C and as such significantly reduce associated osteonecrosis and improve patient outcome and quality of life.
Drilling procedures are important to optimize and ensure the strongest fixation in bone fracture treatment and reconstruction surgery. The mechanistic force models currently available for bovine bones, human spines and human mandibles are not relevant to perform drilling through human femurs. The present study addresses this lack of information and aims to develop the predictive force models for drilling human femurs at different regions and directions. In this study, 10 freshly harvested cadaveric human femurs were included, and a surgical drill bit of 3.2[Formula: see text]mm diameter was used to make 4[Formula: see text]mm deep holes. Different spindle speeds (500, 1000 and 1500[Formula: see text]rpm), feed rates (40, 60 and 80[Formula: see text]mm/min), and apparent density between 0.98 and 1.98[Formula: see text]g/cm3were considered. The optimal parameters [Formula: see text], [Formula: see text], and [Formula: see text] respectively obtained for longitudinal, radial, and circumferential direction could minimize the thrust forces in bone drilling by up to 7.70, 10.50, and 16.20 N, respectively. Validation study demonstrated that the force model developed could predict the thrust force from computed tomography data sets of the patient, only with 5.05%, 6.74%, and 4.91% as a maximum error in longitudinal, radial, and circumferential direction. This important tool can assist to perform complicated surgical operations.
Drilling through bone is one of the common cutting processes involved in many of the orthopedic surgeries. In bone drilling, spindle speed, feed rate, diameter of the drill bit, drill bit geometry and method of cooling are the important parameters to influence the in-situ temperature, drill thrust force and quality characteristics of the drilled hole. Because of the selection of inappropriate drilling parameters, uncontrolled large drilling forces, continuous increase in temperature and mechanical damage to the local host bone were observed. As these adverse effects lead to poor bone–implant contact and often a revision surgery, performing a surgical drilling with optimal parameters is essential to succeed in the surgical procedure. It was observed that in addition to the variations in apparent bone density, the orientation of osteons influences the drilling thrust force and temperature in bone drilling. Ten adult cadaveric human femurs from the age group of 32–65 years were considered and drilling experiments were conducted on proximal-diaphysis, mid-diaphysis and distal-diaphysis regions in the longitudinal, radial and circumferential directions. Bone drilling with different spindle speeds (500, 1000 and 1500[Formula: see text]rpm), feed rates (40, 60 and 80[Formula: see text]mm/min), and apparent density in the range of 0.98[Formula: see text]g/cm3 to 1.98[Formula: see text]g/cm3 was investigated in this work using a 3.20[Formula: see text]mm diameter surgical drill-bit. The generation of in-situ temperature as well as thrust force at each target location was measured using [Formula: see text]-type thermocouple and Kistler[Formula: see text] dynamometer, respectively. Taguchi method based on membership function was used to optimize the drilling process. Then the efficacy of the method in reducing the in-situ temperature and thrust force, and quality of the drilled hole in respect of anatomical region and drilling direction was investigated using pull-out strength of the bone screws. Results revealed that the optimal parameters obtained from the Taguchi method based on membership function could simultaneously minimize the temperature as well as thrust force in bone drilling. The proposed method can be adopted to minimize the temperature and thrust force, and choose the best location nearest to the defect site for strong implant fixation by using CT datasets of the patient as the only input.
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