Highlights
- •Powered instrumentation risks thermal-induced osteonecrosis.
- •Heat generation and cutting efficiency were compared between different burrs.
- •The fluteless burr cuts more efficiently.
- •The fluteless burr generates less heat.
Abstract
Background
Powered instrumentation is often used for bone preparation and/or removal in many
orthopaedic procedures but does risk thermogenesis. This study compares biomechanical
properties of a fluted burr and a novel fluteless resurfacing tool.
Methods
Twenty cadaveric metatarsals were tested with four predetermined cutting forces to
evaluate heat generation and cutting rate for the fluted burr and fluteless resurfacing
tool over 40 s or until a depth of 4 mm was reached. Cutting rate was calculated from
displacement transducer data. Heat generation was measured by thermocouples placed
in the bone adjacent to the burring site. Assuming a body temperature of 37 °C, a
10 °C increase in heat was used as the threshold of inducing osteonecrosis.
Findings
At 1.0 N and 1.7 N, the thermal osteonecrosis threshold was reached at comparable
times between burrs, while the bone removed by the resurfacing tool was on average
five times greater than fluted burr at 1.0 N and over twice as great at 1.7 N. Statistical
analysis of these common cutting forces showed the resurfacing tool had significantly
higher cutting rates (P < 0.01). As a result, the fluted burr produced higher temperatures for the same amount
of bone removal (P < 0.01).
Interpretation
In a cadaveric study, the fluteless resurfacing tool demonstrated higher bone cutting
rates and lower heat generation for the same amount of bone removed than a traditional
fluted burr.
Keywords
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Article info
Publication history
Published online: February 01, 2023
Accepted:
January 24,
2023
Received:
November 1,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
