Research Article| Volume 102, 105898, February 2023

Bone cutting efficiency and heat generation using a traditional fluted Burr and a novel fluteless resurfacing tool


      • 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.



      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.


      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.


      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).


      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.


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        • Abouzgia M.B.
        • James D.F.
        Measurements of shaft speed while drilling through bone.
        J. Oral Maxillofac. Surg. 1995; 53 (p. 1308–15; discussion 1315–6)
        • Bagi C.M.
        • et al.
        Morphological and structural characteristics of the proximal femur in human and rat.
        Bone. 1997; 21: 261-267
        • Call W.H.
        Thermal injury from mastoid bone burrs.
        Ann Otol Rhinol Laryngol. 1978; 87: 43-49
        • Chen Y.C.
        • et al.
        Assessment of heat generation and risk of thermal necrosis during bone burring by means of three-dimensional dynamic elastoplastic finite element modelling.
        Med. Eng. Phys. 2020; 81: 1-12
        • Eriksson A.R.
        • Albrektsson T.
        Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit.
        J. Prosthet. Dent. 1983; 50: 101-107
        • Eriksson A.R.
        • et al.
        Thermal injury to bone. A vital-microscopic description of heat effects.
        Int. J. Oral Surg. 1982; 11: 115-121
        • Eriksson A.R.
        • Albrektsson T.
        • Magnusson B.
        Assessment of bone viability after heat trauma. A histological, histochemical and vital microscopic study in the rabbit.
        Scand. J. Plast. Reconstr. Surg. 1984; 18: 261-268
        • Eriksson A.R.
        • Albrektsson T.
        • Albrektsson B.
        Heat caused by drilling cortical bone. Temperature measured in vivo in patients and animals.
        Acta Orthop. Scand. 1984; 55: 629-631
        • Fincham B.M.
        • Jaeblon T.
        The effect of drill bit, pin, and wire tip design on drilling.
        J Am Acad Orthop Surg. 2011; 19: 574-579
        • Haddad S.L.
        • et al.
        Effects of continuous irrigation during burring on thermal necrosis and fusion strength in a rabbit arthrodesis model.
        Foot Ankle Int. 2014; 35: 796-801
        • Hein C.
        • et al.
        Heat generation during bone drilling: a comparison between industrial and Orthopaedic Drill bits.
        J. Orthop. Trauma. 2017; 31: e55-e59
        • Hillery M.T.
        • Shuaib I.
        Temperature effects in the drilling of human and bovine bone.
        J. Mater. Process. Technol. 1999; 92-93: 302-308
        • Kusins J.R.
        • Tutunea-Fatan O.R.
        • Ferreira L.M.
        Experimental analysis of the process parameters affecting bone burring operations.
        Proc Inst Mech Eng H. 2018; 232: 33-44
        • Kusins J.R.
        • et al.
        Analysis of the process parameters affecting the bone burring process: an in-vitro porcine study.
        Int J Med Robot. 2019; 15e2028
        • Lee J.
        • Chavez C.L.
        • Park J.
        Parameters affecting mechanical and thermal responses in bone drilling: a review.
        J. Biomech. 2018; 71: 4-21
        • Lundskog J.
        Heat and bone tissue. An experimental investigation of the thermal properties of bone and threshold levels for thermal injury.
        Scand. J. Plast. Reconstr. Surg. 1972; 9: 1-80
        • Madjarevic M.
        • et al.
        Biomechanical analysis of functional adaptation of metatarsal bones in statically deformed feet.
        Int. Orthop. 2009; 33: 157-163
        • Matthews L.S.
        • Hirsch C.
        Temperatures measured in human cortical bone when drilling.
        J. Bone Joint Surg. Am. 1972; 54: 297-308
        • Muffly M.T.
        • et al.
        Cadaveric study of bone tissue temperature during pin site drilling using Fluoroptic thermography.
        J. Orthop. Trauma. 2018; 32: e315-e319
        • Natali C.
        • Ingle P.
        • Dowell J.
        Orthopaedic bone drills-can they be improved? Temperature changes near the drilling face.
        J Bone Joint Surg Br. 1996; 78: 357-362
        • Oh H.J.
        • et al.
        Implant Drill characteristics: thermal and mechanical effects of two-, three-, and four-fluted drills.
        Int. J. Oral Maxillofac. Implants. 2017; 32: 483-488
        • Palmisano A.C.
        • et al.
        Comparison of cortical bone drilling induced heat production among common drilling tools.
        J. Orthop. Trauma. 2015; 29: e188-e193
        • Palmisano A.C.
        • et al.
        Heat accumulation during sequential cortical bone drilling.
        J. Orthop. Res. 2016; 34: 463-470
        • Pandey R.K.
        • Panda S.S.
        Drilling of bone: a comprehensive review.
        J Clin Orthop Trauma. 2013; 4: 15-30
        • Shin H.C.
        • Yoon Y.S.
        Bone temperature estimation during orthopaedic round bur milling operations.
        J. Biomech. 2006; 39: 33-39
        • Singh T.S.
        • Yusoff A.H.
        • Chian Y.K.
        How safe is high-speed burring in spine surgery? An in vitro study on the effect of rotational speed and Heat generation in the bovine spine.
        Spine (Phila Pa 1976). 2015; 40 (p. E866–72)
        • Sui J.
        • Sugita N.
        Experimental study of thrust force and torque for drilling cortical bone.
        Ann. Biomed. Eng. 2019; 47: 802-812
        • Tai B.L.
        • et al.
        Temperature prediction in high speed bone grinding using motor PWM signal.
        Med. Eng. Phys. 2013; 35: 1545-1549
        • Tawy G.F.
        • Rowe P.J.
        • Riches P.E.
        Thermal damage done to bone by burring and sawing with and without irrigation in knee arthroplasty.
        J. Arthroplast. 2016; 31: 1102-1108