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Research Paper

A Comparison of the Temperature Rise Generated in Bone by the Use of a Standard Oscillating Saw Blade and the “Precision” Saw Blade

[+] Author and Article Information
Sebastien Lustig

Sydney Orthopaedic Research Institute,
Chatswood, NSW, 2046 Australia;
Albert Trillat Center,
Lyon University Hospital,
Lyon 1, France
e-mail: sebastien.lustig@gmail.com

Sam Oussedik

Sydney Orthopaedic Research Institute,
Chatswood, NSW 2046, Australia

Sam Tam

Sydney Orthopaedic Research Institute,
Chatswood, NSW, 2046 Australia;
School of Aerospace, Mechanical and Mechatronic Engineering,
University of Sydney,
NSW 2006, Australia

Richard Appleyard

Australian School of Advanced Medicine,
Macquarie University,
NSW 2109, Australia

David A. Parker

Sydney Orthopaedic Research Institute,
Chatswood, NSW 2046, Australia

1Corresponding author.

Manuscript received July 9, 2012; final manuscript received January 27, 2013; published online June 24, 2013. Assoc. Editor: William K. Durfee.

J. Med. Devices 7(2), 021006 (Jun 24, 2013) (4 pages) Paper No: MED-12-1087; doi: 10.1115/1.4024159 History: Received July 09, 2012; Revised January 27, 2013

Introduction. Osteonecrosis may be triggered by bone temperatures above 47 °C during routine orthopaedic bone cuts using power-driven saws with potentially negative impacts on bone healing. A new oscillating-tip saw blade design (Precision®; Stryker, Kalamazoo, USA) has been recently developed with a saw blade design that may influence the amount of heat generated. We have, therefore, sought to compare the bone temperature achieved using this new blade design with a standard oscillating saw during a standardized cutting task. Method. Six human cadaveric femora were obtained. Each femur was clamped and a distal femoral cutting jig was applied. An initial cut was performed to visualize the distal metaphyseal bone. The cutting block was then moved 2 mm proximal and a further cut performed, measuring the temperature of the bone with an infrared camera. This was repeated, moving the block 2 mm proximal with each cut, alternating between a standard oscillating saw blade (12 cuts) and the Precision® saw blade (12 cuts). The bone density at the level of each slice was established from a CT scan of each specimen which had been performed prior to the experiment. Results. The two blades did not differ with respect to the integrated mean temperature calculated for each cut (p = 0.89). The average peak temperatures were not significantly different between blades (p = 0.14). There was no significant difference between blades for peak heating rate (p = 0.7), although the area of bone heated above the 47 deg osteonecrotic threshold was significantly (p = 0.04) less for the standard saw blade. Conclusions. The Precision® blade may have advantages over standard oscillating blade, but reduced heat generation was not observed in this study. Indeed, the Precision® blade generated heat that exceeded the bony osteonecrosis threshold in a greater proportion of bone than the standard blade, questioning its use for osteotomy or uncemented knee arthroplasty. Further work should examine modifications to the blade design to better optimize the requirements of speed, accuracy and heat generation.

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Figures

Grahic Jump Location
Fig. 1

Figure showing the differences between Precision® saw (a) and standard saw (b). With the Precision saw, oscillating motion is confined to the tip of the blade, in a direction which is perpendicular to the cutting direction. The shaft of this blade remains stationary during use, on the opposite to a standard oscillating saw.

Grahic Jump Location
Fig. 2

Photograph showing the setting of the experimentation. The femora were mounted in a bench-secured vice (a). An infra-red camera (b) was positioned at 90 degrees to the cut surface of the femur and images recorded during the cutting task (c) to monitor bone temperature.

Grahic Jump Location
Fig. 3

Capture with the infrared camera of the heat output of one cut across the target femur section. The lateral part (darker) hasn't been cut yet. The scale on the side of the picture has been used to analyze the temperature related to every pixel of the screen corresponding to the femoral cut (figure corresponding to a femoral cut with the standard saw).

Grahic Jump Location
Fig. 4

Curves showing for each cut the peak temperature and the area under the curve above the osteonecrotic threshold (47 °C) for both blades

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