Smart Drill for a Streamlined Estimation of the Drilling Angle and Channel Length in Orthopedic Surgical Procedures

The estimation of distances and angles is a routine part of an orthopedic surgical procedure. However, despite their prevalence, these steps are most often performed manually, heavily relying on the surgeon's skill and experience. To address these issues, this study presents a sensor-equipped drill system which enables automatic estimation of the drilling angle and channel length. The angular accuracy and precision of the system were tested over a range of inclination angles and proved to be superior to the manual approach, with mean absolute errors ranging from 1.9 to 4.5 degrees for the manual approach, and from 0.6 to 1.3 degrees with the guided approach. When sensors were used for simultaneous estimation of both the inclination and anteversion angles, the obtained mean absolute errors were 0.35 ± 0.25 and 2 ± 1.33 degrees for the inclination and anteversion angles, respectively. Regarding channel length estimation, using measurements obtained with a Vernier caliper as a reference, the mean absolute error was 0.33 mm and the standard deviation of errors was 0.41 mm. The obtained results indicate a high potential of smart drill systems for improvement of accuracy and precision in orthopedic surgical procedures, enabling better patient clinical outcomes.

Power-Tool Use in Orthopaedic Surgery: Iatrogenic Injury, Its Detection, and Technological Advances: A Systematic Review

Power tools are an integral part of orthopaedic surgery but have the capacity to cause iatrogenic injury. With this systematic review, we aimed to investigate the prevalence of iatrogenic injury due to the use of power tools in orthopaedic surgery and to discuss the current methods that can be used to reduce injury.

Vibration-based drilling depth estimation of bone

Drilling is one of the most common forms of tissue removal procedures, and drilling to a desired depth contributes to avoid injury to the soft tissue beyond and ensure implant stability. The deformation of the human musculoskeletal system has been a common problem in many drilling processes, making it difficult to achieve accurate estimation of the drilling depth. To remedy this problem, a dynamic model is presented to describe the relationship between the axial vibration of the drill and the feed rate. During drilling process, the amplitude of the main harmonic is estimated from the high-frequency component of the acceleration signal, while the short-time integral of the low-frequency part is calculated. Both the initial contact of the drilling tool to the bone and breakthrough are identified by comparing either the harmonic amplitude or the short-time integral. The harmonic amplitude is mapped to the data from a non-contact position sensor tracking the feed rate of the drill. Multiple drilling experiments on both a handheld device and a robotic cutting system demonstrated the effectiveness, stability and accuracy of the method when estimating depth. The mean maximum error for drilling depth estimation is less than 15% of the simulated bone thickness when using the handheld device, while the mean maximum error is less than 5% for the robotic cutting system.

Feed rate control in robotic bone drilling process

The bone drilling process is characterised by various parameters, the most important of which are the feed rate (mm/s) and the drill speed (rpm). They highly reflect the final effects and results of the drilling process, such as mechanical and thermal damages of bone tissue and hole quality. During manual drilling, these parameters are controlled by the surgeon based on his practical skills. But automatic drilling can assure an optimal result of the manipulation where such parameters are under control. During bicortical automatic bone drilling such a process consists of several stages: searching the contact with the first cortex, cortex drilling and automatic stop; searching the contact with the second cortex, cortex drilling and automatic stop; drill bit extraction. This work presents a way to control the feed rate during different stages of the bone drilling process (an original feed rate control algorithm) using the orthopaedic drilling robot (ODRO). The feed rate control is based on a proposed algorithm created and realised by specific software. During bicortical bone drilling process the feed rate takes various values in any stage in the range 0.5-6 mm/s. These values depend on drill bit position and real time force sensor data. The novelty of this work is the synthesis of an original feed rate control algorithm to solve the main problems of bone drilling in orthopaedic surgery - minimisation the drilling time (the heat generation); eliminating of the drill bit slip at the first (near) cortex and the drill bit bending at the second (far) cortex; minimising the risk of micro cracks which causes Traumatic Osteonecrosis; improving hole quality of the drilled holes; eliminating of the drill bit slip and the drill bit bending at the second cortex; minimising the value of the second cortex drill bit penetration by bicortical bone drilling.

Using an admittance algorithm for bone drilling procedures

Bone drilling is a common procedure in many types of surgeries, including orthopedic, neurological and otologic surgeries. Several technologies and control algorithms have been developed to help the surgeon automatically stop the drill before it goes through the boundary of the tissue being drilled. However, most of them rely on thrust force and cutting torque to detect bone layer transitions which has many drawbacks that affect the reliability of the process. This paper describes in detail a bone-drilling algorithm based only on the position control of the drill bit that overcomes such problems and presents additional advantages. The implication of each component of the algorithm in the drilling procedure is analyzed and the efficacy of the algorithm is experimentally validated with two types of bones.

Automatic Bone Drilling in Orthopedic Surgery - Overcoming of the Drill Bit Bending at the Second Cortex

This paper discusses a problem appeared by drill bit bending during bone drilling in the orthopedic surgery, where precision is needed for screws to be implanted. The bone surface has a specific shape and the drill bit may slip a little along the bone before the process start, when a large thrust force is applied by hand-drilling. That could be seen and correct by the surgeon. But he can’t see inside – where the second cortex drilling starts. The drill bit bending leads to the worse screw fixation and even to the bone damage – if the drill bit stays off broken inside. To solve this problem an active force control is made by robot application. Experiments and results are presented.