Analysis of temperature in conventional and ultrasonically-assisted drilling of cortical bone with infrared thermography

Ultrasonic-assisted drilling of cortical and cancellous bone in a comparative point of view

Background

During bone drilling, a common procedure in clinical surgeries, excessive heat generation and drilling force can cause damage to bone tissue, potentially leading to failure of implants and fixation screws or delayed healing. With this in mind, the aim of this study was to evaluate the efficiency of ultrasonic-assisted drilling compared to conventional drilling as a potential method for bone drilling.

Methods

This study examined optimal drilling parameters based on previous findings and investigated both cortical and cancellous bone. In addition to evaluating drilling force and temperature elevation, the effects of these factors on osteonecrosis and micro-crack formation were explored in ultrasonic-assisted and conventional drilling through histopathological assessment and microscopic imaging. To this end, three drilling speeds and two drilling feed-rates were considered as variables in the in vitro experiments. Furthermore, numerical modeling provided insight into temperature distribution during the drilling process in both methods and compared three different vibration amplitudes.

Results

Although temperature elevations were lower in the conventional drilling, ultrasonic-assisted drilling produced less drilling force. Additionally, the latter method resulted in smaller osteonecrosis regions and did not produce micro-cracks in cortical bone or structural damage in cancellous bone.

Conclusions

Ultrasonic-assisted drilling, which caused less damage to bone tissue in both cortical and cancellous bone, was comparatively more advantageous. Notably, this study demonstrated that to determine the superiority of one method over the other, we cannot rely solely on temperature variation results. Instead, we must consider the cumulative effect of both temperature elevation and drilling force.

Optimizing milling parameters based on full factorial experiment and backpropagation artificial neural network of lamina milling temperature prediction model

BACKGROUND

Milling operations of laminae in spinal surgery generate high temperatures, which can lead to thermal injury and osteonecrosis and affect the biomechanical effects of implants, ultimately leading to surgical failure.

OBJECTIVE

In this paper, a backpropagation artificial neural network (Bp-ANN) temperature prediction model was developed based on full factorial experimental data of laminae milling to optimize the milling motion parameters and to improve the safety of robot-assisted spine surgery.

METHODS

A full factorial experiment design were used to analyze the parameters affecting the milling temperature of laminae. The experimental matrixes were established by collecting the corresponding cutter temperature Tc and bone surface temperature Tb for the milling depth, feed speed and different bone densities. The Bp-ANN lamina milling temperature prediction model was constructed from experiment data.

RESULTS

Increasing milling depth increases bone surface and cutter temperature. Increasing feed speed had little effect on cutter temperature, but decreased bone surface temperature. Increasing bone density of laminae increased cutter temperature. The Bp-ANN temperature prediction model had best training results in the 10th epoch, and there is no overfitting (training set R= 0.99661, validation set R= 0.85003, testing set R= 0.90421, all temperature data set R= 0.93807). The goodness of fit R of Bp-ANN was close to 1, indicating that the predicted temperature was in good agreement with the experiment measurements.

CONCLUSION

This study can help spinal surgery-assisted robot to select appropriate motion parameters at different density bones to improve lamina milling safety.

Investigation of transient machining in the cortical bone drilling process by conventional and axial vibration-assisted drilling methods

A temperature exceeding the safety threshold and excessive drilling force occurring during bone drilling may lead to irreversible damage to bone tissue and postoperative complications. Previous studies have shown that vibration-assisted drilling methods could have lower temperatures and drilling forces than those of the conventional drilling method; we hypothesized that the main reason for these reductions stems from the differences in the transient machining processes between conventional and vibration-assisted drilling methods. To investigate these differences, comparative experiments and two-dimensional finite element models were performed and developed. The differences in the transient machining processes were verified by experimentation and clearly exhibited by the finite element models. Compared with the steady cutting process that produced continuous-spiral chips in the conventional drilling method, transient machining in the low-frequency vibration-assisted drilling method was a periodically dynamic cutting-separation process that produced uniform petal chips with specific settings of drilling and vibration parameters. Moreover, the transient machining process in the ultrasonic vibration-assisted drilling method was transformed into a combined action with high-speed impact and negative rake angle cutting processes; this action produced a large proportion of powdery chips. Therefore, it could be concluded that the superposed axial vibration significantly changed the transient machining process and radically changed the mechanical state and thermal environment; these changes were the main reason for the apparent differences in the drilling performance levels.

Prediction of temperature elevation in rotary ultrasonic bone drilling using machine learning models: An in-vitro experimental study

Bone drilling is frequently used during orthopaedic surgeries to treat the fractured part of the bone. A major concern for surgeons is the increase in temperature during real-time orthopaedic bone drilling. The temperature elevation at the bone-tool interface may cause permanent death of regenerative soft tissues and cause thermal osteonecrosis. A robust predictive machine-learning model is suggested in this in-vitro research for monitoring temperature rise during surgery. The objective of the present work is to introduce different machine learning algorithms for predicting temperature elevations in rotary ultrasonic bone drilling. Different machine-learning models were compared with the standard response surface methodology. The performance and accuracy of different predictive models were compared at different error metrics. It was witnessed that support vector machines performed the best for predicting the change in temperature in comparison to other predictive models. Moreover, the error metrics for statistical response surface methodology analysis were comparatively higher than the machine learning algorithms. By using machine learning models, it is possible to predict temperature rise during bone drilling.

Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study

PURPOSE

The goal of this preliminary report was to show the use of novel Ultrasound (US) technology for anterior cruciate ligament (ACL) reconstruction surgery and evaluate its feasibility for the creation of a rectangular femoral bone tunnel during an arthroscopic procedure in a human cadaver model.

METHODS

Two fresh frozen human cadaver knees were prepared for arthroscopic rectangular femoral tunnel completion using a prototype US device (OLYMPUS EUROPA SE & CO. KG). The desired rectangular femoral tunnel was intended to be located in the femoral anatomical ACL footprint. Its tunnel aperture was planned at 10 × 5 mm and a depth of 20 mm should be achieved. For one knee, the rectangular femoral tunnel was realized without a specific cutting guide and for the other with a 10 × 5 mm guide. One experienced orthopedic surgeon performed the two procedures consecutively. The time for femoral tunnel completion was evaluated. CT scans with subsequent three-dimensional image reconstructions were performed in order to evaluate tunnel placement and configuration.

RESULTS

In the two human cadaver models the two 10 × 5x20mm rectangular femoral tunnels were successfully completed and located in the femoral anatomical ACL footprint without adverse events. The time for femoral tunnel completion was 14 min 35 s for the procedure without the guide and 4 min 20 s with the guide.

CONCLUSION

US technology can be used for the creation of a rectangular femoral bone tunnel during an arthroscopic ACL reconstruction procedure. The use of a specific cutting guide can reduce the time for femoral tunnel completion. Additional experience will further reduce the time of the procedure.

Surface quality and pullout strength of ultrasonically-assisted drilling cortical bone

Bone surgery is a complex process involving sustainable and healthy human recuperation, but poor surface quality and loose implant fixtures can affect the recovery time of orthopedic patients. However, it has been demonstrated that the application of ultrasonic vibration during drilling procedures can improve the success of bone remediation procedures. The focus of the present paper was on the investigation of surface quality and pullout strength of drilled holes. After analyzing the special kinematic characteristics of the ultrasonically-assisted drilling (UAD), UAD testing using fresh cortical bone was carried out and compared with the results obtained after conventional drilling (CD) procedures. Surface roughness measurements and microscope examination were used to evaluate surface quality, and an electro-mechanical tensile machine was used to measure pullout resistance. The test findings indicated that surface roughness was reduced by 17-68.7% when using UAD; the axial pullout strength of screws inserted into UAD holes was significantly increased by 4.28-30.1% compared to that of CD. It was found also that low spindle speeds and high feed rates reduced surface quality and the stability of the inserted cortical screws. The findings demonstrated that UAD produced better surface quality and higher pullout strengths, which could provide greater stability for implants and improved post-operative recovery.

Analysis of machining process and thermal conditions during vibration-assisted cortical bone drilling based on generated bone chip morphologies

When the temperature during bone drilling exceeds the safety threshold, the bone tissue surrounding the drilling site can be irreversibly damaged. To investigate the influence of vibration-assisted drilling (VAD) methods on the temperature increase during bone drilling and the causes for temperature increase, drilling experiments were performed on fresh bovine femur samples. The morphology and granularity distribution of the generated bone chips were innovatively used to directly compare the machining processes and thermal conditions of conventional drilling (CD), low-frequency vibration-assisted drilling (LFVAD), and ultrasonic vibration-assisted drilling (UVAD). The experimental results indicated that LFVAD produced the lowest temperature increase of 31.4°C, whereas UVAD produced the highest temperature increase of 44.1°C with the same drilling parameters. Additionally, the morphologies and granularity distributions of the bone chips significantly differed among these methods. We concluded that the smaller temperature increase in LFVAD was mainly attributed to the improved thermal conditions resulting from the periodic cutting/separation motion and the reliable geometric chip-breaking mechanism. In contrast, the unfavourable thermal conditions of UVAD were caused by the higher applied frequency, which created a significantly larger amount of friction heat. This was the main cause for the highest observed temperature increase, resulting in bone crushing processes that generated additional heat.

Experimental study of temperature rise during bone drilling process

An excessive temperature rise during bone drilling processes can result in osteonecrosis or impairment of the osteogenic potential. However, the effect of geometric parameters of the surgical drill bit, drilling process parameters, and the bone type on the temperature rise have not been fully investigated. In this study, thermocouples are introduced to measure the temperature rise, and three experimental designs are utilized separately to investigate the temperature rise with respect to each parameter, identify the effect of important drill geometric parameters and their interaction on the temperature rise, and develop a quadratic model of the temperature rise with respect to process parameters. The results show that the temperature rise can be significantly affected by geometric parameters of the surgical drill bit, drilling process parameters, and the bone type. The effects of the point angle and the interaction between the web thickness and the helix angle on the temperature rise are very significant. The quadratic regression equation obtained using response surface methodology can provide accurate predictions under a wide range of drilling process conditions, and the optimized drilling process parameters are in good agreement with the experimental results.

Experimental investigation on the effect of drill quality on the performance of bone drilling

Bone drilling is a well-known process in operative fracture treatment and reconstructive surgery. The cutting ability of the drill is lost when used for multiple times. In this study, the effect of different levels of drill wear on bone temperature, drilling force, torque, delamination around the drilling region and surface roughness of the hole was investigated using a series of experiments. Experimental results demonstrated that the wear of the drill is strongly related to the drilling force, torque, temperature and surface roughness of the drilled hole. Statistical analysis was performed to find the effect of various factors on multiple response variables in the bone drilling process. The favorable conditions for bone drilling are obtained when feed rate, drill speed and the roughness of the cutting edge of the drill were fixed at 30 mm, 2000 rpm and up to 2 mm, respectively. Further, analysis of variance (ANOVA) was performed to determine the factor with a significant impact on the response variables. F-test and p-value indicated that the feed rate had the highest effect on grey relational grade followed by the roughness of the drill. This study suggests that the sharp drill along with controlled drilling speed and feed rate may be used for safe and efficient surgical drilling in bone.

Characteristics of ultrasound device: a new technology for bone curettage and excavation

Background

Ultrasonic (US) devices are used in laparoscopic, dental, and spinal surgeries, while it is difficult to use for the joint under irrigation and perfusion solutions due to lack of power. A new US device is developed with greater voltage improvement and has been implemented in the arthroscopic field. The aim is to compare the characteristics of the US devices with the conventional ones in water.

Methods

Twenty bone blocks from the porcine femur were settled in a holder in water. A 4.0 mm diameter abrader burr moved 15 mm along the long axis of the bone block in ten blocks for three times. A 4.3 mm wide curette blade powered by ultrasonic vibration was moved in the same manner in the other ten blocks. The gutter shape, including the gutter depth and the bottom angle of the gutter, and the curetted area ratio of the gutter were assessed.

Forty bones blocks from the porcine femurs were clamped with a holder in water, while the cortical bone surface must be located on the side. A 5 mm diameter drill excavated the bone along the previously-inserted guide wire to the 15 mm depth for twenty blocks. Next, the US excavation probe of 5x4mm rectangular shape was moved to the same depth in the other twenty blocks. Each ten block was cut in half along the bone tunnel and was assessed the surface roughness at three area, while the cross-sectional area (CSA) of the tunnel were measured and the ratio of the measured CSA was calculated based on an expected CSA in the remaining ten blocks for each device.

Results

The depth of curettage and bottom angle were significantly smaller with the US device than with the abrader burr at all planes, while the curetted area ratio created by each device was mostly equal to the other. Surface roughness was similar in two evacuating devices except one area. CSA ratio with the US excavation device was significantly smaller than that with the drill.

Conclusion

US curettage has an advantage to flatly curette bone surfaces, while a bone tunnel can be accurately created with the US device.

Experimental investigation of the temperature elevation in bone drilling using conventional and vibration-assisted methods

Bone drilling is widely used in orthopaedics for inserting screws and fixing prostheses. Thermal necrosis is one of the major problems that may seriously affect post-operative recovery. Accordingly, this paper mainly focuses on comparing the influences of conventional drilling (CD), ultrasonic vibration-assisted drilling (UVAD) and low-frequency vibration-assisted drilling (LFVAD) methods, and drilling parameters on the temperature elevation in bone drilling process. A full factorial experiment was performed, and the temperatures were measured using an infrared camera. The lowest temperature elevation was obtained by LFVAD compared with CD and UVAD at the same drilling conditions. Setting CD as a reference, the maximum difference between LFVAD and CD was approximately -4 °C, whereas that between UVAD and CD was approximately 16 °C. The temperature elevation increases linearly with the spindle speed and follows an inverted U-shaped curve, with the feed rate having a peak at 40 min/mm in each drilling method. The results were discussed with regard to the features of LFVAD and UVAD. It was expected that the LFVAD could achieve minimal thermal damage and attain better results in the medical bone drilling process.

In-vitro experimental study of histopathology of bone in vibrational drilling

Drilling is a common surgical procedure for fracture treatment and reconstruction in multiple surgical fields, including orthopaedics, neurology, and dentistry. Drilling delicate tissue (such as bone) with a hard metallic tool is considered notorious for inducing mechanical and thermal damage, which can adversely affect osseointegration and may weaken the bond between the bone and implant, or other fixative devices anchoring the bone. The aim of this study is to explore the benefits of vibrational drilling (VD) in overcoming the complications associated with conventional drilling (CD). Drilling tests were performed on fresh cortical bone with the intention of investigating the effect of a range of frequencies, in combination with drilling speed and feed rate, on biological damage around the drilling region using histological sections of skeletally mature bone. The study examined the most influential factors and optimal combination of parameters for safe and efficient drilling in bone. Results from Taguchi grey relational analysis showed that a lower drilling speed and feed rate combined with a frequency of 20 kHz were favourable parameters for safe drilling in bone. Accordingly, VD using controlled parameters may be an alternative to CD in bone surgical procedures.

Temperature changes associated with bone drilling in an orbital model: comparison of ultrasonic bone curette and conventional high-speed rotational drill

Purpose: Thermal injury to the optic nerve is a potential complication of bony decompression of the orbital apex. An animal model was used to compare and contrast temperature change while removing orbital bone with ultrasonic and conventional drills. Methods: Two devices, Sonopet ultrasonic bone curette and TPS CORE Micro drill, were used to remove bone from six unpreserved exenterated porcine orbits at fixed distances from the optic canal while temperature was recorded. Increasing irrigation flow rate and decreasing saline temperature with the ultrasonic bone curette were also investigated. Results: The mean change in temperature at the optic canal using the ultrasonic bone curette with 18 ml/min 24°C irrigation was +7.2 ± 3.3°C (range 3.3-12.7°C) at 60 s, and using the rotational drill was +1.7 ± 1.3°C (range 0.1-3.3°C), representing a statistically significant increase above baseline for both drills (p < 0.01 for each). The difference in temperature change between drills was statistically significant (p < 0.01). When irrigation fluid was changed from room temperature saline (24°C), rate 18 ml/min to chilled (10°C) irrigation saline, rate 40 ml/min, the magnitude of the mean temperature increase was reduced by 3.1°C, p < 0.05. Conclusions: In this orbital decompression model, both ultrasonic and rotational drills induced a rise in temperature. This increase was significantly greater with the ultrasonic bone curette, measuring up to 13.7°C. Clinicians should be aware of the potential for temperature spikes when decompressing the orbital apex. Increasing irrigation flow rate and using chilled saline may mitigate increases in temperature.

Rotary ultrasonic drilling on bone: A novel technique to put an end to thermal injury to bone

Bone drilling is common in orthopedic procedures and the heat produced during conventional experimental drilling often exceeds critical temperature of 47 °C and induces thermal osteonecrosis. The osteonecrosis may be the reason for impaired healing, early loosening and implant failure. This study was undertaken to control the temperature rise by interrupted cutting and reduced friction effects at the interface of drill tool and the bone surface. In this work, rotary ultrasonic drilling technique with diamond abrasive particles coated on the hollow drill tool without any internal or external cooling assistance was used. Experiments were performed at room temperature on the mid-diaphysis sections of fresh pig bones, which were harvested immediately after sacrifice of the animal. Both rotary ultrasonic drilling on bone and conventional surgical drilling on bone were performed in a five set of experiments on each process using identical constant process parameters. The maximum temperature of each trial was recorded by K-type thermocouple device. Ethylenediaminetetraacetic acid decalcification was done for microscopic examination of bone. In this comparative procedure, rotary ultrasonic drilling on bone produced much lower temperature, that is, 40.2 °C ± 0.4 °C and 40.3 °C ± 0.2 °C as compared to that of conventional surgical drilling on bone, that is, 74.9 °C ± 0.8 °C and 74.9 °C ± 0.6 °C with respect to thermocouples fixed at first and second position, respectively. The conventional surgical drilling on bone specimens revealed gross tissue burn, microscopic evidence of thermal osteonecrosis and tissue injury in the form of cracks due to the generated force during drilling. But our novel technique showed no such features. Rotary ultrasonic drilling on bone technique is robust and superior to other methods for drilling as it induces no thermal osteonecrosis and does not damage the bone by generating undue forces during drilling.

In-situ tool wear monitoring and its effects on the performance of porcine cortical bone drilling: a comparative in-vitro investigation

Background

Drilling is one of the most widely used process in orthopaedic surgical operation and the same drill bit is used a number of times in hospitals. Using the same drill bit a several times may be the cause of osteosynthesis and osteonecrosis.

Methods

In the present work, the effect of repeated orthopaedic surgical twist drill bit on the tool wear, force, torque, temperature and chip morphology during porcine cortical bone drilling is studied. Results were compared with rotary ultrasonic drilling (RUD) on the same bone using a hollow drill tool coated with diamond grains. A sequence of 200 experiments (100 with each process, RUD and CD) were performed with constant process parameters.

Results

Wear area on the drill bit is significantly increased as the drill bit is used repeatedly in CD, whereas no attritious wear was found on the diamond coated grains in RUD.

Conclusions

Comparative results showed that cutting force, torque and temperature increased as a function of tool wear in CD as the same drill bit was used a number of times. No significant variation in the cutting force and torque was observed in RUD as the number of drilled holes increased.

In-vitro analysis of forces in conventional and ultrasonically assisted drilling of bone

BACKGROUND

Drilling of bone is widely performed in orthopaedics for repair and reconstruction of bone. Current paper is focused on the efforts to minimize force generation during the drilling process. Ultrasonically Assisted Drilling (UAD) is a possible option to replace Conventional Drilling (CD) in bone surgical procedures.

OBJECTIVE

The purpose of this study was to investigate and analyze the effect of drilling parameters and ultrasonic parameters on the level of drilling thrust force in the presence of water irrigation.

METHODS

Drilling tests were performed on young bovine femoral bone using different parameters such as spindle speeds, feed rates, coolant flow rates, frequency and amplitudes of vibrations.

RESULTS

The drilling force was significantly dropped with increase in drill rotation speed in both types of drilling. Increase in feed rate was more influential in raising the drilling force in CD compared to UAD. The force was significantly dropped when ultrasonic vibrations up to 10 kHz were imposed on the drill. The drill force was found to be unaffected by the range of amplitudes and the amount of water supplied to the drilling region in UAD.

CONCLUSIONS

Low frequency vibrations with irrigation can be successfully used for safe and efficient drilling in bone.

Exploring thermal anisotropy of cortical bone using temperature measurements in drilling

BACKGROUND

Bone drilling is widely used in orthopaedics for fracture treatment, reconstructive surgery and bone biopsy. Heat generation in bone drilling can cause rise in bone temperature resulting in prolonged healing time or loosening of fixation.

OBJECTIVE

The purpose of this study was to investigate thermal anisotropy of bone by measuring the level of temperature in bone drilling with and without cooling conditions in two anatomical directions.

METHODS

Drilling tests were performed on bovine cortical bone. A total of fifteen specimens were used to obtain data for statistical analysis. Temperature near the cutting zone was measured in two anatomical directions. i.e. along the longitudinal and circumferential direction. Temperature distribution was also found in the two prescribed directions. Analysis of variance (ANOVA) was used to identify significant drilling parameter affecting bone temperature.

RESULTS

Drilling speed, feed rate and drill size were found influential parameters affecting bone temperature. Higher drilling speed, feed rate, and large drill size were found to cause elevated temperature in bone. Much lower temperature was measured in bone when cooling fluid was supplied to the drilling region. Experimental results revealed lower temperatures in the circumferential direction compared to the longitudinal direction.

CONCLUSIONS

Thermal anisotropy for heat transport was found in the bone. This study recommends lower drilling speed and feed rate and cooling for controlling rise in bone temperature.