Thermal Damage Done to Bone by Burring and Sawing With and Without Irrigation in Knee Arthroplasty

Tawy, Gwenllian; Rowe, Peter; Riches, Philip

doi:10.1016/j.arth.2015.11.002

Cited by 53 publications

(22 citation statements)

References 36 publications

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“…Irrigated, low-speed, low-force cutting devices should be used to prevent overheating of the specimens, and thus reduce thermal and mechanical damage. 9 , 204 Diamond is a material that has been shown to be resistant to wear 205 and is biocompatible. 206 Thus, where possible, this should be used for tool materials.…”

Section: Discussionmentioning

confidence: 99%

Standardizing compression testing for measuring the stiffness of human bone

Zhao

Arnold

et al. 2018

Bone & Joint Research

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ObjectivesThe ability to determine human bone stiffness is of clinical relevance in many fields, including bone quality assessment and orthopaedic prosthesis design. Stiffness can be measured using compression testing, an experimental technique commonly used to test bone specimens in vitro. This systematic review aims to determine how best to perform compression testing of human bone.MethodsA keyword search of all English language articles up until December 2017 of compression testing of bone was undertaken in Medline, Embase, PubMed, and Scopus databases. Studies using bulk tissue, animal tissue, whole bone, or testing techniques other than compression testing were excluded.ResultsA total of 4712 abstracts were retrieved, with 177 papers included in the analysis; 20 studies directly analyzed the compression testing technique to improve the accuracy of testing. Several influencing factors should be considered when testing bone samples in compression. These include the method of data analysis, specimen storage, specimen preparation, testing configuration, and loading protocol.ConclusionCompression testing is a widely used technique for measuring the stiffness of bone but there is a great deal of inter-study variation in experimental techniques across the literature. Based on best evidence from the literature, suggestions for bone compression testing are made in this review, although further studies are needed to establish standardized bone testing techniques in order to increase the comparability and reliability of bone stiffness studies.Cite this article: S. Zhao, M. Arnold, S. Ma, R. L. Abel, J. P. Cobb, U. Hansen, O. Boughton. Standardizing compression testing for measuring the stiffness of human bone. Bone Joint Res 2018;7:524–538. DOI: 10.1302/2046-3758.78.BJR-2018-0025.R1.

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Section: Discussionmentioning

confidence: 99%

Standardizing compression testing for measuring the stiffness of human bone

Zhao

Arnold

et al. 2018

Bone & Joint Research

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“…This physiological repair mechanism is also effective in the event of thermal damage to the bone. Surgical procedures often involve the risk of overheating [4,5]. Cutting, rotating, and vibrating instruments are used regularly in contact with the hard and soft tissue under cooling [6].…”

Section: Introductionmentioning

confidence: 99%

Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants—A Systematic Review on Preclinical In Vivo Research

et al. 2020

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Purpose: Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. Methods: Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in English and German language journals until 1 November 2019. The outcome measures were temperature-exposure intervals and laser settings effecting bone damage. Furthermore, investigated parameters were the bone-to-implant contact ratios (BIC) and infrabony pockets around dental implants after thermal treatment. For quality assessment of studies, the CAMARADES study quality checklist was applied. Results: A total of 455 animals in 25 animal studies were included for data extraction after screening of 45 titles from 957 selected titles of the MEDLINE (PubMed), The Cochrane Library, Embase and Web of Science search. The threshold values for bone necrosis ranged between 47 °C and 55 °C for 1 min. A threshold value for cryoinsult and laser treatment has not yet been defined. However, temperatures in the vicinity of 3.5 °C produce a histologically proven effect on the bone and in the surrounding tissue. At 50 °C for 1 min, BIC values significantly decreased and infrabony pockets increased. Bone quality had an influence on the outcome, as cancellous bone suffered higher bone damage from thermal treatment compared to cortical bone. Conclusion: No clear threshold value for bone necrosis is available according to the current literature for warm and cold stimuli. More in-depth and clinical studies are required to provide further insights in assessing the potential of thermal necrosis for implant removal.

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“…Prior testing of bovine and caprine trabecular bone samples confirmed that this method yielded a sufficiently polished surface for nanoindentation. Care was taken to ensure that the post-polishing thicknesses of the subject's medial and lateral samples were the same and that at least 0.5 mm of bone was ground to remove the regions damaged by the oscillating surgical saw 27 . After grinding, the samples were cleaned in the ultrasonic bath for 5 min, then put back in the tubes and kept refrigerated at 4 °C before the indentation phase began.…”

Section: Methodsmentioning

confidence: 99%

Tibial subchondral trabecular bone micromechanical and microarchitectural properties are affected by alignment and osteoarthritis stage

Renault

Carmona

Tzioupis

et al. 2020

Sci Rep

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At advanced knee osteoarthritis (OA) stages subchondral trabecular bone (STB) is altered. Lower limb alignment plays a role in OA progression and modify the macroscopic loading of the medial and lateral condyles of the tibial plateau. How the properties of the STB relate to alignment and OA stage is not well defined. OA stage (KL scores 2-4) and alignment (HKA from 17° Varus to 8° Valgus) of 30 patients were measured and their tibial plateau were collected after total knee arthroplasty. STB tissue elastic modulus, bone volume fraction (BV/TV) and trabecula thickness (Tb.Th) were evaluated with nanoindentation and µCT scans (8.1 µm voxel-size) of medial and lateral samples of each plateau. HKA and KL scores were statistically significantly associated with STB elastic modulus, BV/TV and Tb.Th. Medial to lateral BV/TV ratio correlated with HKA angle (R = −0.53, p = 0.016), revealing a higher ratio for varus than valgus subjects. STB properties showed lower values for KL stage 4 patients. Tissue elastic modulus ratios and BV.TV ratios were strongly correlated (R = 0.81, p < 0.001). Results showed that both micromechanical and microarchitectural properties of STB are affected by macroscopic loading at late stage knee OA. For the first time, a strong association between tissue stiffness and quantity of OA STB was demonstrated.

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Thermal Damage Done to Bone by Burring and Sawing With and Without Irrigation in Knee Arthroplasty

Abstract: These results suggest that irrigating bone during resection could prevent osteonecrosis onset.

Cited by 53 publications

References 36 publications

Standardizing compression testing for measuring the stiffness of human bone

Standardizing compression testing for measuring the stiffness of human bone

Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants—A Systematic Review on Preclinical In Vivo Research

Tibial subchondral trabecular bone micromechanical and microarchitectural properties are affected by alignment and osteoarthritis stage

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