Temperatures Measured in Human Cortical Bone when Drilling

Matthews, Larry S.; Hirsch, Carl

doi:10.2106/00004623-197254020-00008

Cited by 424 publications

(370 citation statements)

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“…Drill-bits are also used in the preparation of bony tunnels, such as in anterior cruciate ligament reconstruction. Drilling is associated with the conversion of mechanical work energy into thermal energy causing a transient rise in temperature of adjacent bone and soft tissues to above normal physiological levels (Matthews and Hirsch 1972;Lavelle and Wedgwood 1980;Eriksson and Albrektsson 1984;Eriksson, Albrektsson et al 1984b;Abouzgia and Symington 1996;Natali, Ingle et al 1996;Toews, Bailey et al 1999;Bachus, Rondina et al 2000;Davidson and James 2003;Augustin, Davila et al 2008;Franssen, van Diest et al 2008;Bertollo, Milne et al 2010). Primary sources of this thermal energy are plastic deformation and shear failure of bone and friction at the machining face.…”

Section: Introductionmentioning

confidence: 99%

Drilling of Bone: Practicality, Limitations and Complications Associated with Surgical Drill-Bits

Bertollo¹,

Walsh²

2011

Biomechanics in Applications

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Section: Introductionmentioning

confidence: 99%

Drilling of Bone: Practicality, Limitations and Complications Associated with Surgical Drill-Bits

Bertollo¹,

Walsh²

2011

Biomechanics in Applications

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“…Augustin et al reported in their review of cortical drilling a threshold level for bone survival during implant site preparation of 47°C with a drilling time below one minute [8]. Externally applied cooling with saline solution, an increase in applied feed-rate and increased rotational speed of the drill led to a smaller increase in temperature at the bone surface [15][16][17][18]. Stability of osteosynthesis was reduced with thermally damaged bone tissue possibly due to reabsorption phenomena around the screws [19].…”

Section: Introductionmentioning

confidence: 99%

Different thermal conductivity in drilling of cemented compared with cementless hip prostheses in the treatment of periprosthetic fractures of the proximal femur—an experimental biomechanical analysis

Brand

Klotz²,

Hassel³

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the different temperature levels whilst drilling cemented and cementless hip prostheses implanted in bovine femora, and to evaluate the insulating function of the cement layer. Methods Standard hip prostheses were implanted in bovine donor diaphyses, with or without a cement layer. Drilling was then performed using high-performance-cutting drills with a reinforced core, a drilling diameter of 5.5 mm and cooling channels through the tip of the drill for constantly applied internal cooling solution. An open type cooling model was used in this setup. Temperature was continuously measured by seven thermocouples placed around the borehole. Thermographic scans were also performed during drilling. Results At the cemented implant surface, the temperature never surpassed 24.7°C when constantly applied internal cooling was used. Without the insulating cement layer (i.e. during drilling of the cementless bone-prosthesis construct), the temperature increased to 47°C. Conclusion Constantly applied internal cooling can avoid structural bone and soft tissue damage during drilling procedures. With a cement layer, the temperatures only increased to non-damaging levels. The results could be useful in the treatment of periprosthetic fractures with intraprosthetic implant fixation.

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“…In human cadaver bone studies, Caillouette et al and Brooks et al report temperature generation at the bone-cement interface of 39 •C and 80 •C, respectively (Brooks et al, 1993;Caillouette et al, 1991b). This is less than that generated by high speed drills (140 •C) (Matthews and Hirsch, 1972). It had previously been demonstrated that the threshold for bone viability is a temperature of greater than 47 •C for a duration of 1min or more (Eriksson and Albrektsson, 1983).…”

Section: Protein Denaturation/necrosismentioning

confidence: 83%

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

OʼDaly

Morris

Gavin³

et al. 2008

Journal of Materials Processing Technology

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Ab s t r a c t High-power low-frequency ultrasound in the range 20-60 kHz has wide ranging clinical applications in surgical and medical instruments for biological tissue cutting, ablation or fragmentation, and removal. Despite widespread clinical application and common device operating characteristics, there is an incomplete understanding of the mechanism of tissue failure, removal and damage. The relative contribution of cavitation, direct mechanical impact and thermal effects to each process for specific tissue types remains unclear. Different and distinct mechanisms and rates of tissue removal are observed for interaction with soft and hard tissue types. Device operating parameters known to affect the interaction include frequency, peak-peak tip amplitude, suction and application time. To date, there has been little analysis of the effect of variations in, and interactions of, these parameters on tissue removal and damage for individual biological tissue types. Potential controllable damage mechanisms occurring in tissues include alteration in global biomechanical properties, histomorphological changes, protein denaturation and tissue necrosis. This paper presents a critical review of the literature on the clinical application, mechanism of tissue interaction, removal and residual tissue damage. It describes known mechanisms for distinct tissue types.

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Temperatures Measured in Human Cortical Bone when Drilling

Cited by 424 publications

References 0 publications

Drilling of Bone: Practicality, Limitations and Complications Associated with Surgical Drill-Bits

Drilling of Bone: Practicality, Limitations and Complications Associated with Surgical Drill-Bits

Different thermal conductivity in drilling of cemented compared with cementless hip prostheses in the treatment of periprosthetic fractures of the proximal femur—an experimental biomechanical analysis

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

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