Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133 Milano, Italy.
Sensors (Basel). 2021 Sep 18;21(18):6267. doi: 10.3390/s21186267.
The preparation of bone for the insertion of an osseointegrated transfemoral implant and the insertion process are performed at very low speeds in order to avoid thermal damages to bone tissue which may potentially jeopardize implant stability. The aim of this study was to quantify the temperature increase in the femur at different sites and insertion depths, relative to the final implant position during the stepwise implantation procedure.
The procedure for installation of the osseointegrated implant was performed on 24 femoral specimens. In one specimen of each pair, the surgery was performed at the clinically practiced speed, while the speed was doubled in the contralateral specimen. Six 0.075 mm K fine gauge thermocouples (RS Components, Sorby, UK) were inserted into the specimen at a distance of 0.5 mm from the final implant surface, and six were inserted at a distance of 1.0 mm.
Drilling caused a temperature increase of <2.5 °C and was not statistically significantly different for most drill sizes (0.002 < < 0.845). The mean increase in temperature during thread tapping and implant insertion was <5.0 °C, whereas the speed had an effect on the temperature increase during thread tapping.
Drilling is the most time-consuming part of the surgery. Doubling the clinically practiced speed did not generate more heat during this step, suggesting the speed and thus the time- and cost-effectiveness of the procedure could be increased. The frequent withdrawal of the instruments and removal of the bone chips is beneficial to prevent temperature peaks, especially during thread tapping.
为了避免可能危及植入物稳定性的骨组织热损伤，将骨准备用于插入骨整合式股骨植入物和插入过程都是以非常低的速度进行的。本研究的目的是量化在逐步植入过程中，相对于最终植入位置，不同部位和插入深度的股骨温度升高。
在 24 个股骨标本上进行了骨整合式植入物安装程序。在每对标本中的一个标本中，手术以临床实践的速度进行，而在对侧标本中速度提高了一倍。在距最终植入物表面 0.5 毫米的位置插入了六个 0.075 毫米 K 细规热电偶（RS Components，Sorby，英国），在距最终植入物表面 1.0 毫米的位置插入了六个热电偶。
钻孔引起的温度升高<2.5°C，对于大多数钻头尺寸，这在统计学上没有显著差异（0.002< <0.845）。在攻丝和植入物插入过程中，温度升高的平均值<5.0°C，而速度对攻丝过程中的温度升高有影响。
钻孔是手术中最耗时的部分。将临床实践的速度提高一倍并不会在这个步骤中产生更多的热量，这表明可以提高速度，从而提高手术的时间和成本效益。频繁地拔出器械和清除骨屑有助于防止温度峰值，特别是在攻丝过程中。
