4.4 Article

Thermographic assessment of heat-induced cellular damage during orthopedic surgery

Journal

MEDICAL ENGINEERING & PHYSICS
Volume 83, Issue -, Pages 100-105

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.medengphy.2020.05.014

Keywords

Bone; Thermal necrosis; Apoptosis; Surgical cutting; Drilling

Funding

  1. China Postdoctoral Science Foundation [2019M652401, 2019TQ0107]

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The heat generated during orthopedic surgery can cause thermal damage to bone cells, leading to cell necrosis, death, and bone resorption. In this study, the drill-exit surface in cortical bone drilling was firstly investigated by infrared thermography to understand the thermal characteristics of bone cutting. In order to mimic the short-term thermal condition of high temperature during surgical cutting, the osteoblasts were exposed to heat shock for short periods of time to investigate the effect of cutting heat on the bone. Necrosis and apoptosis were investigated immediately after heat shock for 2 s, 5 s, and 15 s at 50 degrees C, 60 degrees C, 70 degrees C, and 80 degrees C, respectively. The cells were then incubated for 4 days at 37 degrees C and analyzed by fluorescein annexin V-FITC/PI double staining. The temperature and heat-duration were precisely controlled by a novel heating approach. In comparison to the control group (37 degrees C), immediate necrotic and apoptotic response to heat shock was found in cells exposed to 50 degrees C for 5 s (11.8%, p<0.05); however, the response was negligible in cells exposed to 50 degrees C for 2 s. In addition, recovery was found in the group exposed to 50 degrees C and 60 degrees C for 2 s (p <= 0.05) after incubation for 4 days. Cell damage depends on the magnitude and duration of heat exposure. These findings provide fundamental knowledge for future developments of surgical tool design and cutting methods. (c) 2020 IPEM. Published by Elsevier Ltd. All rights reserved.

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