Evaluation of potential tissue heating during percutaneous drill-assisted bone sampling in an in vivo porcine study

Stefan M Niehues,Keno K Bresssem,Sefer Elezkurtaj,Bernd Hamm,Christoph Erxleben,Janis Vahldiek,Lisa C Adams

doi:10.1007/s00256-021-03890-w

Stefan M Niehues, Keno K Bresssem + Show 5 more

Open Access

https://doi.org/10.1007/s00256-021-03890-w

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Abstract

BackgroundMinimally invasive, battery-powered drilling systems have become the preferred tool for obtaining representative samples from bone lesions. However, the heat generated during battery-powered bone drilling for bone biopsies has not yet been sufficiently investigated. Thermal necrosis can occur if the bone temperature exceeds a critical threshold for a certain period of time.PurposeTo investigate heat production as a function of femur temperature during and after battery-powered percutaneous bone drilling in a porcine in vivo model.MethodsWe performed 16 femur drillings in 13 domestic pigs with an average age of 22 weeks and an average body temperature of 39.7 °C, using a battery-powered drilling system and an intraosseous temperature monitoring device. The standardized duration of the drilling procedure was 20 s. The bone core specimens obtained were embedded in 4% formalin, stained with haematoxylin and eosin (H&E) and sent for pathological analysis of tissue quality and signs of thermal damage.ResultsNo significant changes in the pigs’ local temperature were observed after bone drilling with a battery-powered drill device. Across all measurements, the median change in temperature between the initial measurement and the temperature measured after drilling (at 20 s) was 0.1 °C. Histological examination of the bone core specimens revealed no signs of mechanical or thermal damage.ConclusionOverall, this preliminary study shows that battery-powered, drill-assisted harvesting of bone core specimens does not appear to cause mechanical or thermal damage.

Highlights

Bone biopsies are obtained to determine the aetiology of bone lesions by subsequent histological examination
Thermal necrosis has been reported in operative fracture treatment and reconstructive surgery due to an excessive increase in local temperature during extended drilling procedures [4]
If the temperature exceeds a critical threshold for a certain period of time, a denaturing process begins to develop in the tissue, which has a negative effect on the mechanical properties of the bone and may

Summary

Introduction

Bone biopsies are obtained to determine the aetiology of bone lesions by subsequent histological examination. The heat generation during battery-powered single-hole bone drilling for bone sampling has not yet been sufficiently examined. If the temperature exceeds a critical threshold for a certain period of time, a denaturing process begins to develop in the tissue, which has a negative effect on the mechanical properties of the bone and may. No final consensus has yet been reached regarding the critical temperature threshold and duration of the procedure for thermal necrosis to occur [6]. Thermal necrosis can occur if the bone temperature exceeds a critical threshold for a certain period of time. Histological examination of the bone core specimens revealed no signs of mechanical or thermal damage. Conclusion Overall, this preliminary study shows that battery-powered, drill-assisted harvesting of bone core specimens does not appear to cause mechanical or thermal damage

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