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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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References

Alam, K., Mitrofanov, A., and Silberschmidt, V., 2010, “Thermal Analysis of Orthogonal Cutting of Cortical Bone Using Finite Element Simulations,” Int. J. Exp. Comput. Biomech., 1(3), pp. 236–251. [CrossRef]
Cardoni, A., MacBeath, A., and Lucas, M., 2006, “Methods for Reducing Cutting Temperature in Ultrasonic Cutting of Bone,” Ultrasonics, 22(44), pp. 37–42. [CrossRef]
Albrektsson, T., and Linder, L., 1981, “Intravital, Long-Term Follow-Up of Autologous Experimental Bone Grafts,” Arch. Orthop. Trauma Surg., 98(3), pp. 189–193. [CrossRef] [PubMed]
Eriksson, A., Albrektsson, T., Grane, B., and McQueen, D., 1982, “Thermal Injury to Bone: A Vital-Microscopic Description of Heat Effects,” Int. J. Oral Surg., 11(2), pp. 115–121. [CrossRef] [PubMed]
Eriksson, R. A., and AlbrektssonT., 1984, “The Effect of Heat on Bone Regeneration: An Experimental Study in the Rabbit Using the Bone Growth Chamber,” J. Oral Maxillofac Surg., 42(11), pp. 705–711. [CrossRef] [PubMed]
Augustin, G., Davila, S., Udiljak, T., Vedrina, D. S., and Bagatin, D., 2009, “Determination of Spatial Distribution of Increase in Bone Temperature During Drilling by Infrared Thermography: Preliminary Report,” Arch. Orthop. Trauma Surg., 129(5), pp. 703–709. [CrossRef] [PubMed]
Krause, W. R., 1987, “Orthogonal Bone Cutting: Saw Design and Operating Characteristics,” J. Biomech. Eng., 109(3), pp. 263–271. [CrossRef] [PubMed]
Malvisi, A., Vnedruscolo, P., Morici, F., Martelli, S., and Marcacci, M., 2000, “Milling Versus Sawing: Comparison of Temperature Elevation and Clinical Performance During Bone Cutting,” Lect. Notes Comput. Sci., 1935, pp. 1238–1244. [CrossRef]
Sydney, S. E., Pickering, S. A., Bell, C. G., and Crawford, R., 2007, “Reducing Metal Debris Generation During Total Knee Arthroplasty,” Orthopedics30(12), pp. 999–1000. [PubMed]
Kalender, W. A., 1992, “A Phantom for Standardization and Quality Control in Spinal Bone Mineral Measurements by QCT and DXA: Design Considerations and Specifications,” Med. Phys., 19(3), pp. 583–586. [CrossRef] [PubMed]
Schileo, E., Dall'ara, E., Taddei, F., Malandrino, A., Schotkamp, T., Baleani, M., VicecontiM., 2008, “An Accurate Estimation of Bone Density Improves the Accuracy of Subject-Specific Finite Element Models,” J. Biomech., 41(11), pp. 2483–2491. [CrossRef] [PubMed]
Christie, J., 1981, “Surgical Heat Injury of Bone,” Injury, 13(3), pp. 188–190. [CrossRef] [PubMed]
Lundskog, J., 1972, “Heat and Bone Tissue. An Experimental Investigation of the Thermal Properties of Bone and Threshold Levels for Thermal Injury,” Scand. J. Plast. Reconstr Surg., 9, pp. 1–80. [PubMed]
Augustin, G., Davila, S., Udilljak, T., Staroveski, T., Brezak, D., and Babic, S., 2012, “Temperature Changes During Cortical Bone Drilling With a Newly Designed Step Drill and an Internally Cooled Drill,” Int. Orthop., 36(7), pp. 1449–1456. [CrossRef] [PubMed]
Firoozbakhsh, K., Moneim, M. S., Mikola, E., and Haltom, S., 2003, “Heat Generation During Ulnar Osteotomy With Microsagittal Saw Blades,” Iowa Orthop. J., 23, pp. 46–50. [PubMed]
Shin, H. C., and Yoon, Y. S., 2006, “Bone Temperature Estimation During Orthopaedic Round Bur Milling Operations,” J. Biomech., 39(1), pp. 33–39. [CrossRef] [PubMed]
Eriksson, A. R., and Albrektsson, T., 1983, “Temperature Threshold Levels for Heat-Induced Bone Tissue Injury: A Vital-Microscopic Study in the Rabbit,” J. Prosthet. Dent., 50(1), pp. 101–107. [CrossRef] [PubMed]
Eriksson, A. R., Albrektsson, T., and Albrektsson, B., 1984, “Heat Caused by Drilling Cortical Bone: Temperature Measured In Vivo in Patients and Animals,” Acta Orthop. Scand., 55(6), pp. 629–631. [CrossRef] [PubMed]
Larsen, S. T., and Ryd, L., 1989, “Temperature Elevation During Knee Arthroplasty,” Acta Orthop. Scand., 60(4), pp. 439–442. [CrossRef] [PubMed]
Brisman, D. L., 1996, “The Effect of Speed, Pressure, and Time on Bone Temperature During the Drilling of Implant Sites,” Int. J. Oral Maxillofac. Implants, 11(1), pp. 35–37. [PubMed]
Bachus, K. N., Rondina, M. T., and Hutchinson, D. T., 2000, “The Effects of Drilling Force on Cortical Temperatures and Their Duration: An In Vitro Study,” Med. Eng. Phys., 22(10), pp. 685–691. [CrossRef] [PubMed]
Matthews, L. S., and Hirsch, C., 1972, “Temperatures Measured in Human Cortical Bone When Drilling,” J. Bone Joint Surg. Am., 54(2), pp. 297–308. [PubMed]
Toksvig-Larsen, S., Ryd, L., and Lindstrand, A., 1991, “On the Problem of Heat Generation in Bone Cutting. Studies on the Effects on Liquid Cooling,” J. Bone Joint Surg. Br., 73(1), pp. 13–15. [PubMed]
Sydney, S. E., Lepp, A. J., Whitehouse, S. L., and Crawford, R. W., “Noise Exposure Due to Orthopedic Saws in Simulated Total Knee Arthroplasty Surgery,” J Arthroplasty, 22(8), pp. 1193–1197. [CrossRef] [PubMed]
Dimitris, K., Taylor, B. C., and Steensen, R. N., 2010, “Excursion of Oscillating Saw Blades in Total Knee Arthroplasty,” J. Arthroplasty, 25(1), pp. 158–160. [CrossRef] [PubMed]
Mavcic, B., and Antolic, V., 2012, “Optimal Mechanical Environment of the Healing Bone Fracture/Osteotomy,” Int. Orthop., 36(4), pp. 689–695. [CrossRef] [PubMed]

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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