Power tool use in orthopaedic surgery: iatrogenic injury, its detection and technological advances

Background: Power tools are an integral part to orthopaedic surgery but have the capacity to cause iatrogenic injury. This systematic review aimed to investigate the prevalence of iatrogenic injury due to power tools in orthopaedic surgery and discuss the current methods 9that can be used to reduce this. Methods: A systematic review of all English language articles using a keyword search was undertaken in Medline, Embase, PubMed and Scopus databases. Exclusion criteria included injuries related to cast saw, temperature induced damage and complications not clearly related to power tool use. Results: 3694 abstracts were retrieved, and 88studies were included in the final analysis. Only a few studies and individual case reports directly looked at prevalence of injury due to power tools. This included 2 studies looking at frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%),2 studies investigating frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%)and 3 studies investigating vascular injury during total joint arthroplasty (124 vascular injuries involving 138 blood vessels,0.13% and 0.1% incidence)in addition to 1 questionnaire sent electronically to surgeons. There are multiple methods to prevent damage during the use of power tools. These include robotics, Revised Manuscript (Maximum 3000 Words) simulation, specific drill settings and real-time feedback techniques such as spectroscopy and electromyography. Conclusion: Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations the use of advanced technologies to reduce the chance of iatrogenic injury should be considered. Clinical Relevance: Power tools used during orthopaedic surgery have the potential to cause iatrogenic injury through mechanisms such as plunging or over-sawing. Understanding the prevalence of these injuries and mechanisms to increase safety would be useful to surgeons in their daily practice and have the potential to reduce iatrogenic injury in future

Haptics-based Modeling and Simulation of Micro-Implants Surgery

Ph.DDOCTOR OF PHILOSOPH

Graphic Processing Units (GPUs)-Based Haptic Simulator for Dental Implant Surgery

This paper presents a haptics-based training simulator for dental implant surgery. Most of the previously developed dental simulators are targeted for exploring and drilling purpose only. The penalty-based contact force models with spherical-shaped dental tools are often adopted for simplicity and computational efficiency. In contrast, our simulator is equipped with a more precise force model adapted from the Voxmap-PointShell (VPS) method to capture the essential features of the drilling procedure, with no limitations on drill shape. In addition, a real-time torque model is proposed to simulate the torque resistance in the implant insertion procedure, based on patient-specific tissue properties and implant geometry. To achieve better anatomical accuracy, our oral model is reconstructed from cone beam computed tomography (CBCT) images with a voxel-based method. To enhance the real-time response, the parallel computing power of GPUs is exploited through extra efforts in data structure design, algorithms parallelization, and graphic memory utilization. Results show that the developed system can produce appropriate force feedback at different tissue layers during pilot drilling and can create proper resistance torque responses during implant insertion

Modeling and rendering for development of a virtual bone surgery system

A virtual bone surgery system is developed to provide the potential of a realistic, safe, and controllable environment for surgical education. It can be used for training in orthopedic surgery, as well as for planning and rehearsal of bone surgery procedures...Using the developed system, the user can perform virtual bone surgery by simultaneously seeing bone material removal through a graphic display device, feeling the force via a haptic deice, and hearing the sound of tool-bone interaction --Abstract, page iii

Drilling in cortical bone: a finite element model and experimental investigations

Bone drilling is an essential part of many orthopaedic surgery procedures, including those for internal fixation and for attaching prosthetics. Estimation and control of bone drilling forces are critical to prevent drill-bit breakthrough, excessive heat generation, and mechanical damage to the bone. An experimental and computational study of drilling in cortical bone has been conducted. A 3D finite element (FE) model for prediction of thrust forces experienced during bone drilling has been developed. The model incorporates the dynamic characteristics involved in the process along with geometrical considerations. An elastic-plastic material model is used to predict the behaviour of cortical bone during drilling. The average critical thrust forces and torques obtained using FE analysis are found to be in good agreement with the experimental results

Experimental and numerical investigations of bone drilling for the indication of bone quality during orthopaedic surgery

Bone drilling is an essential part of many orthopaedic surgical procedures, including those for internal fixation and for attaching prosthetics. Drilling into bone is a fundamental skill that can be both very simple, such as drilling through long bones, or very difficult, such as drilling through the vertebral pedicles where incorrectly drilled holes can result in nerve damage, vascular damage or fractured pedicles. Also large forces experienced during bone drilling may promote crack formation and can result in drill overrun, causing considerable damage to surrounding tissues. Therefore, it is important to understand the effect of bone material quality on the bone drilling forces to select favourable drilling conditions, and improve orthopaedic procedures. [Continues.

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems