A study of the effects of high-speed rotary instruments on bone repair in dogs

Costich, Emmett R.; Youngblood, Philip J.; Walden, James M.

doi:10.1016/0030-4220(64)90359-7

Cited by 69 publications

(32 citation statements)

References 6 publications

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“…Water coolant with high-speed drills reduces bone damage in oral surgery (Costich et al 1964, Moss 1964). Davidson and James (2003) found that when drilling cortical bone, the temperature did not exceed 50°C when a water coolant was used.…”

Section: Discussionmentioning

confidence: 99%

Maximum temperatures of 89°C recorded during the mechanical preparation of 35 femoral heads for resurfacing

Baker¹,

Whitehouse²,

Kilshaw³

et al. 2011

Acta Orthopaedica

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Background and purpose We noticed that our instruments were often too hot to touch after preparing the femoral head for resurfacing, and questioned whether the heat generated could exceed temperatures known to cause osteonecrosis.Patients and methods Using an infra-red thermal imaging camera, we measured real-time femoral head temperatures during femoral head reaming in 35 patients undergoing resurfacing hip arthroplasty. 7 patients received an ASR, 8 received a Cormet, and 20 received a Birmingham resurfacing arthroplasty.Results The maximum temperature recorded was 89°C. The temperature exceeded 47°C in 28 patients and 70°C in 11. The mean duration of most stages of head preparation was less than 1 min. The mean time exceeded 1 min only on peripheral head reaming of the ASR system. At temperatures lower than 47°C, only 2 femoral heads were exposed long enough to cause osteonecrosis. The highest mean maximum temperatures recorded were 54°C when the proximal femoral head was resected with an oscillating saw and 47°C during peripheral reaming with the crown drill. The modified new Birmingham resurfacing proximal femoral head reamer substantially reduced the maximum temperatures generated. Lavage reduced temperatures to a mean of 18°C.Interpretation 11 patients were subjected to temperatures sufficient to cause osteonecrosis secondary to thermal insult, regardless of the duration of reaming. In 2 cases only, the length of reaming was long enough to induce damage at lower temperatures. Lavage and sharp instruments should reduce the risk of thermal insult during hip resurfacing.

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Section: Discussionmentioning

confidence: 99%

Maximum temperatures of 89°C recorded during the mechanical preparation of 35 femoral heads for resurfacing

Baker¹,

Whitehouse²,

Kilshaw³

et al. 2011

Acta Orthopaedica

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“…The effects of irrigation during drilling were not currently examined. If used, inigation would have reduced the temperature of the drill bit and bone, cleared away bone debris, and minimized friction, thereby decreasing the force and torque required [30,65,67,70,71]. Also, irrigation may have minimized fiuctuations or noise In the data traces and improved the quality of the drill hole.…”

Section: Journal Of Biomechanjcal Engineeringmentioning

confidence: 95%

Biomechanical Measurements of Surgical Drilling Force and Torque in Human Versus Artificial Femurs

MacAvelia¹,

Salahi

Olsen³

et al. 2012

Journal of Biomechanical Engineering

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Few experimental studies have examined surgical drilling in human bone, and no studies have inquired into this aspect for a popular commercially-available artificial bone used in biomechanical studies. Sixteen fresh-frozen human femurs and five artificial femurs were obtained. Cortical specimens were mounted into a clamping system equipped with a thrust force and torque transducer. Using a CNC machine, unicortical holes were drilled in each specimen at 1000 rpm, 1250 rpm, and 1500 rpm with a 3.2 mm diameter surgical drill bit. Feed rate was 120 mm/min. Statistical significance was set at p < 0.05. Force at increasing spindle speed (1000 rpm, 1250 rpm, and 1500 rpm), respectively, showed a range for human femurs (198.4 ± 14.2 N, 180.6 ± 14.0 N, and 176.3 ± 11.2 N) and artificial femurs (87.2 ± 19.3 N, 82.2 ± 11.2 N, and 75.7 ± 8.8 N). For human femurs, force at 1000 rpm was greater than at other speeds (p ≤ 0.018). For artificial femurs, there was no speed effect on force (p ≥ 0.991). Torque at increasing spindle speed (1000 rpm, 1250 rpm, and 1500 rpm), respectively, showed a range for human femurs (186.3 ± 16.9 N·mm, 157.8 ± 16.1 N·mm, and 140.2 ± 16.4 N·mm) and artificial femurs (67.2 ± 8.4 N·mm, 61.0 ± 2.9 N·mm, and 53.3 ± 2.9 N·mm). For human femurs, torque at 1000 rpm was greater than at other speeds (p < 0.001). For artificial femurs, there was no difference in torque for 1000 rpm versus higher speeds (p ≥ 0.228), and there was only a borderline difference between the higher speeds (p = 0.046). Concerning human versus artificial femurs, their behavior was different at every speed (force, p ≤ 0.001; torque, p < 0.001). For human specimens at 1500 rpm, force and torque were linearly correlated with standardized bone mineral density (sBMD) and the T-score used to clinically categorize bone quality (R ≥ 0.56), but there was poor correlation with age at all speeds (R ≤ 0.37). These artificial bones fail to replicate force and torque in human cortical bone during surgical drilling. To date, this is the largest series of human long bones biomechanically tested for surgical drilling.

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“…Therefore, the feed rate may significantly affect the temperature distribution in the bone [19]. Consistently, several studies have suggested that the increased feed rate results in lower temperatures within the bone [3,5,17,24,33]. Many of those studies used a constant load rather than a constant feed rate during experimentation.…”

Section: Introductionmentioning

confidence: 95%