title: Thermal Damage Done to Bone by Burring and Sawing With and Without Irrigation in Knee Arthroplasty.
abstract: Heat from bone resecting tools used in knee surgery can induce thermal osteonecrosis, potentially causing aseptic implant loosening. This study compared oscillating saws to burrs in terms of temperature generation and histologic damage. Use of irrigation to reduce bone temperature was also investigated.
  
  
  
  Temperatures were recorded during sawing and burring with or without irrigation (uncooled or cooled). Histologic analyses were then carried out. Differences between groups were tested statistically (α = 0.05).
  
  
  
  On average, burring produced higher temperatures than sawing (P < .001). When uncooled irrigation was used, bone temperatures were significantly lower in sawed bone than in burred bone (P < .001). Irrigation lowered temperatures and thermal damage depths and increased osteocyte viability (P < .001).
  
  
  
  These results suggest that irrigating bone during resection could prevent osteonecrosis onset.
authors.affiliation: The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom.
authors.forename: Gwenllian F
authors.initials: GF
authors.lastname: Tawy
authors.affiliation: The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rowe
authors.affiliation: The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Riches
mesh_terms: D000818:Animals; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001831:Body Temperature; D001842:Bone and Bones / Q000293:injuries* / Q000601:surgery*; D002417:Cattle; D002470:Cell Survival; D006358:Hot Temperature / Q000009:adverse effects*; D010011:Osteocytes / Q000502:physiology; D010020:Osteonecrosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D007507:Therapeutic Irrigation
keywords: bone buring; bone overheating; bone sawing; irrigation; knee arthroplasty; osteonecrosis