Background Bone fracture treatment usually involves restoring of the fractured parts to their initial position and immobilizing them until the healing takes place. Drilling of bone is common to produce hole for screw insertion to fix the fractured parts for immobilization. Orthopaedic drilling during surgical process causes increase in the bone temperature and forces which can cause osteonecrosis reducing the stability and strength of the fixation. Methods A comprehensive review of all the relevant investigations carried on bone drilling is conducted. The experimental method used, results obtained and the conclusions made by the various researchers are described and compared. Result Review suggests that the further improvement in the area of bone drilling is possible. The systematic review identified several consequential factors (drilling parameters and drill specifications) affecting bone drilling on which there no general agreement among investigators or are not adequately evaluated. These factors are highlighted and use of more advanced methods of drilling is accentuated. The use of more precise experimental set up which resembles the actual situation and the development of automated bone drilling system to minimize human error is addressed. Conclusion In this review, an attempt has been made to systematically organize the research investigations conducted on bone drilling. Methods of treatment of bone fracture, studies on the determination of the threshold for thermal osteonecrosis, studies on the parameters influencing bone drilling and methods of the temperature measurement used are reviewed and the future work for the further improvement of bone drilling process is highlighted.

Drilling of bone: A comprehensive review.

Accurate measurements of hip outcomes and function are vital in the study of hip pathology. Additionally, outcome measures can also be used in the clinical realm to track progress of treatment. Several outcome measures have been developed in an effort to accurately assess hip symptoms and function. A 2011 review of the most commonly used hip outcome scores was previously published in this journal (1). Since then, a number of additional studies focusing on these outcome scores have been published to further refine our knowledge and potential utility of hip outcome scores. The purpose of this review is to provide updated information regarding the most commonly used hip outcome scores, which include the Harris Hip Score (HHS), the Hip Disability and Osteoarthritis Outcome Score (HOOS), the PatientReported Outcomes Measurement Information System (PROMIS), the Oxford Hip Score (OHS), the Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), the American Academy of Orthopaedic Surgeons (AAOS) Hip and Knee Questionnaire, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Table 1 provides information on practical applications of these scores. Table 2 provides a summary of the psychometric properties of the included hip outcome scores.

Measures of Hip Function and Symptoms.

An experimental investigation on thermal exposure during bone drilling

Modeling and experimentation of bone drilling forces

Bone cutting is an important procedure in most surgery operations; therefore, understanding the mechanism by which the chip forms is important to design tools for optimising the surgery process. However, only very few studies to address this issue exist. In this paper, a transition from shear cutting, shear-crack cutting and fracture cutting modes with the increase of uncut chip thickness in orthogonal bone cutting was presented. To address these phenomena, a fracture mechanics based cutting model was proposed for the chip formation and cutting process. The influence of the anisotropy of bone to the orthogonal cutting was studied in reference to chip formation and thus, considered in the model to explain the chip morphologies in different cutting directions relative to the bone fibres (i.e. osteon). The experimental result shows to be consistent well with the proposed model yielding a maximum error of predicted transition uncut chip thickness of 10%. On the other hand, analysis of surface morphology revealed that significant differences exist in material damage mode related to the cutting mode and direction. Moreover, the proposed bone orthogonal cutting mechanism was also validated by the cutting force analysis from both static and dynamic components points of view. Based on this study, a maximum uncut chip thickness in a unique anisotropic material as bone to guide the selection of more advanced cutting process (e.g. drilling, milling and sawing) was proposed.

JuEun Lee

Papers

An experimental investigation on thermal exposure during bone drilling

Modeling and experimentation of bone drilling forces

A new thermal model for bone drilling with applications to orthopaedic surgery.