Singh Ravinder Pal, Pandey Pulak Mohan, Mir Muzamil Ahmad, Mridha Asit Ranjan
Department of Mechanical Engineering, Maharishi Markandeshwar (Deemed to be University), Mullana, India.
Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India.
J Biomed Mater Res B Appl Biomater. 2022 May;110(5):1023-1033. doi: 10.1002/jbm.b.34975. Epub 2021 Dec 2.
Undue heat production in surgical bone drilling leads to osteonecrosis and can be an important cause of failure of osteosynthesis, impaired healing, and loosening of implants following orthopedic surgery. The present work aims to minimize heat production below the critical temperature for thermal osteonecrosis (i.e., 47°C) and obviate thermal bone damage due to drilling. A total of 20 samples from the shaft of the human femur were obtained at autopsies and drilling was performed at room temperature by an operation theater (OT) compatible rotary ultrasonic bone drilling (RUBD) machine. K-type thermocouples were used to measure the temperature rise during drilling and the physical changes of the bone samples were observed by infrared gama camera. Light microscopic and transmission electron microscopic studies were performed to evaluate the bone cell damage. The maximum temperature recorded in RUBD (40.6 ± 1.3°C) was much below the critical temperature for thermal osteonecrosis (p < .05) at the rotational speed of 2000 rpm. Light microscopic and ultrastructural studies also revealed that there was no appreciable damage to the bone cells. Conventional bone drilling (CD) on the other hand recorded much higher temperature (66.6 ± 3.2°C), tissue burn and bone cell necrosis. Hence, RUBD machine has a potentiality for its use in orthopedic surgery and may provide better results.
外科骨钻孔过程中产生的过多热量会导致骨坏死，并且可能是骨科手术后骨合成失败、愈合受损以及植入物松动的重要原因。目前的工作旨在将热量产生降低到热骨坏死的临界温度（即47°C）以下，并避免钻孔导致的热骨损伤。通过尸检从人股骨干获取了总共20个样本，并在室温下使用与手术室（OT）兼容的旋转超声骨钻孔（RUBD）机器进行钻孔。使用K型热电偶测量钻孔过程中的温度升高，并通过红外伽马相机观察骨样本的物理变化。进行光镜和透射电镜研究以评估骨细胞损伤。在2000转/分钟的转速下，RUBD记录的最高温度（40.6±1.3°C）远低于热骨坏死的临界温度（p<0.05）。光镜和超微结构研究还表明，骨细胞没有明显损伤。另一方面，传统骨钻孔（CD）记录的温度要高得多（66.6±3.2°C），伴有组织烧伤和骨细胞坏死。因此，RUBD机器在骨科手术中有应用潜力，可能会提供更好的结果。
