A review of cutting mechanics and modeling techniques for biological materials

A scientometric analysis of bone cutting tools & methodologies: Mapping the research landscape

This study undertakes a Scientometric analysis of bone-cutting tools, investigating a corpus of 735 papers from the Scopus database between 1941 and 2023. It employs bibliometric methodologies such as keyword coupling, co-citation, and co-authorship analysis to map the intellectual landscape and collaborative networks within this research domain. The analysis highlights a growing interest and significant advancements in bone-cutting tools, focusing on their design, the materials used, and the cutting processes involved. It identifies key research fronts and trends, such as the emphasis on surgical precision, material innovation, and the optimization of tool performance. Further, the study reveals a broad collaboration among researchers from various disciplines, including engineering, materials science, and medical sciences, reflecting the field's interdisciplinary nature. Despite the progress, the analysis points out several gaps, notably in tool design optimization and the impact of materials on bone health. This comprehensive review not only charts the evolution of bone-cutting tool research but also calls attention to areas requiring further investigation, aiming to inspire future studies that address these identified gaps and enhance surgical outcomes.

A novel computational fracture toughness model for soft tissue in needle insertion

During the process of percutaneous puncture vascular intervention operation in endoscopic liver surgery, high precision needle manipulation requires the accurate needle tissue interaction model where the tissue fracture toughness is an important parameter to describe the tissue crack propagation, as well as to estimate tissue deformation and target displacement. However, the existing studies on fracture toughness estimation did not consider Young's modulus and the organ capsule structure. In this paper, a novel computational fracture toughness model is proposed considering insertion velocity, needle diameter and Young's modulus in insertion process, where the fracture toughness is determined by the tissue surface deformation, which was estimated through energy modeling using integrated shell element and three-dimensional solid element. The testbed is built to study the effect of different insertion velocities, needle diameters and Young's modulus on fracture toughness. The experiment result shows that the estimated result of computational fracture toughness model agrees well with the physical experimental data. In addition, the sensitivity analysis of different factors is conducted. Meanwhile, the model robustness analysis is investigated with different observation noises of Young's modulus and puncture displacement.

Puncturing of soft tissues: experimental and fracture mechanics-based study

The integrity of soft materials against puncturing is of great relevance for their performance because of the high sensitivity to local rupture caused by rigid sharp objects. In this work, the mechanics of puncturing is studied with respect to a sharp-tipped rigid needle with a circular cross section, penetrating a soft target solid. The failure mode associated with puncturing is identified as a mode-I crack propagation, which is analytically described by a two-dimensional model of the target solid, taking place in a plane normal to the penetration axis. It is shown that the force required for the onset of needle penetration is dependent on two energy contributions, that are, the strain energy stored in the target solid and the energy consumed in crack propagation. More specifically, the force is found to be dependent on the fracture toughness of the material, its stiffness and the sharpness of the penetrating tool. The reference case within the framework of small strain elasticity is first investigated, leading to closed-form toughness parameters related to classical linear elastic fracture mechanics. Then, nonlinear finite element analyses for an Ogden hyperelastic material are presented. Supporting the proposed theoretical framework, a series of puncturing experiments on two commercial silicones is presented. The combined experimental-theoretical findings suggest a simple, yet reliable tool to easily handle and assess safety against puncturing of soft materials.

Investigation of transient machining in the cortical bone drilling process by conventional and axial vibration-assisted drilling methods

A temperature exceeding the safety threshold and excessive drilling force occurring during bone drilling may lead to irreversible damage to bone tissue and postoperative complications. Previous studies have shown that vibration-assisted drilling methods could have lower temperatures and drilling forces than those of the conventional drilling method; we hypothesized that the main reason for these reductions stems from the differences in the transient machining processes between conventional and vibration-assisted drilling methods. To investigate these differences, comparative experiments and two-dimensional finite element models were performed and developed. The differences in the transient machining processes were verified by experimentation and clearly exhibited by the finite element models. Compared with the steady cutting process that produced continuous-spiral chips in the conventional drilling method, transient machining in the low-frequency vibration-assisted drilling method was a periodically dynamic cutting-separation process that produced uniform petal chips with specific settings of drilling and vibration parameters. Moreover, the transient machining process in the ultrasonic vibration-assisted drilling method was transformed into a combined action with high-speed impact and negative rake angle cutting processes; this action produced a large proportion of powdery chips. Therefore, it could be concluded that the superposed axial vibration significantly changed the transient machining process and radically changed the mechanical state and thermal environment; these changes were the main reason for the apparent differences in the drilling performance levels.

Micro-mechanism study on tissue removal behavior under medical waterjet impact using coupled SPH-FEM

To fully grasp the numerical characteristics of the interaction process between medical waterjet and soft tissue, the smoothed particle hydrodynamics (SPH)-finite element method (FEM) was used in the simulation of this complex process to avoid the unstable error caused by indirect measurement in experiments. The SPH was applied to the numerical simulation of medical waterjet, and a three-dimensional model of gelatin sample was proposed with the FEM. The impact process between two extremely deformed materials was reproduced, and the established model was verified by comparison with experimental data; the comparison showed relatively consistent results. The separation effect under three operating modes was deduced with the stress and strain range. For the vertical impact condition, the higher the waterjet impact pressure is, the higher the biological tissue deformation bulge height is. For oblique intrusion, the longitudinal separation rate decreases and the kerf width increases with the increase of the incident angle. For the moving impact condition, with the increase of the waterjet moving speed, the longitudinal high-stress distribution range of the impact object decreases slightly.

Cone cracks in tissue-mimicking hydrogels during hypodermic needle insertion: the role of water content

Needle insertion into soft biological tissues is a common process in various surgical procedures. During insertion, soft biological tissues with different water contents undergo large deformation often leading to uncontrollable cracks and tissue damage. Despite the numerous experimental studies and numerical modelling of needle-tissue interaction, the results do not show any consistency mainly due to the heterogeneity of tissue properties and opaqueness. In this context, understanding the fracture behaviour of soft tissues during needle insertion is important for minimally invasive surgeries and other medical procedures. Recently, we showed that the needle insertion into a transparent, tissue-mimicking polyacrylamide (PAAm) hydrogel causes periodic cone cracks. In this work, we systematically varied the water content of the PAAm hydrogel in the preparation state and performed needle insertion experiments using a hypodermic needle at a constant velocity to study the fracture characteristics of the PAAm hydrogel. The results show that the number of peaks, the magnitudes of the insertion forces, and corresponding cone cracks decrease with increasing water content. Furthermore, we discussed the influence of water on cone crack fracture characteristics, cone angle, periodicity, crack speed and fracture energy release rate. These results provide a better understanding of the fracture processes of soft tissues with different water concentrations such as the lung, liver, and brain during needle insertion and the control of tissue damage during needle insertion involved in medical procedures.

Microfluidic Surgery in Single Cells and Multicellular Systems

Microscale surgery on single cells and small organisms has enabled major advances in fundamental biology and in engineering biological systems. Examples of applications range from wound healing and regeneration studies to the generation of hybridoma to produce monoclonal antibodies. Even today, these surgical operations are often performed manually, but they are labor intensive and lack reproducibility. Microfluidics has emerged as a powerful technology to control and manipulate cells and multicellular systems at the micro- and nanoscale with high precision. Here, we review the physical and chemical mechanisms of microscale surgery and the corresponding design principles, applications, and implementations in microfluidic systems. We consider four types of surgical operations: (1) sectioning, which splits a biological entity into multiple parts, (2) ablation, which destroys part of an entity, (3) biopsy, which extracts materials from within a living cell, and (4) fusion, which joins multiple entities into one. For each type of surgery, we summarize the motivating applications and the microfluidic devices developed. Throughout this review, we highlight existing challenges and opportunities. We hope that this review will inspire scientists and engineers to continue to explore and improve microfluidic surgical methods.

On the relationship between cutting and tearing in soft elastic solids

Unique observations of cutting energy in silicone elastomers motivate a picture of soft fracture that qualitatively and quantitatively links far-field tearing with push cutting for the first time. For blades of decreasing tip radii, the cutting energy decreases until it reaches a plateau that suggests a threshold for failure. A super-molecular damage zone, necessary for new surface creation, is defined using the tip radius at the onset of this threshold. Modifying the classic Lake-Thomas theory, in which failure occurs within a molecular plane, to this super-molecular zone provides order-of-magnitude agreement with the cutting energy threshold. Together, the threshold fracture energy and damage length scale define criteria for failure that, when implemented in finite element simulation, quantitatively reproduce the increase in cutting energy with increasing blade radius outside of the plateau. The rate of increase depends on the constitutive response of the material, with more neo-Hookean solids requiring a larger failure force per incremental increase in blade radius as observed experimentally. This combination of a geometry-independent failure threshold (from the cutting energy plateau) and a need to account for the role of material deformability in the stress concentration found at the crack tip (from the rate of cutting energy increase with blade radius) align with the discovery of a new dimensionless group. This new parameter proportionally maps cutting energy to the energy required to tear a sample under far-field loading conditions by using ultimate properties obtained in uniaxial tension.

Needle insertion-induced quasiperiodic cone cracks in hydrogel

Needle insertion, a standard process for various minimally invasive surgeries, results in tissue damage which sometimes leads to catastrophic outcomes. Opaqueness and inhomogeneity of the tissues make it difficult to observe the underlying damage mechanisms. In this paper, we use transparent and homogeneous polyacrylamide hydrogel as a tissue mimic to investigate the damages caused during needle insertion. The insertion force shows multiple events, characterised by a gradual increase in the force followed by a sharp fall. Synchronised recording of the needle displacement into the gel shows that each event corresponds to propagation of stable cone crack. Though sporadic uncontrolled cracking has been discussed earlier, this is the first report of nearly periodic, stable and well-controlled 3-D cone cracks inside the hydrogel during deep penetration. We show that the stress field around the needle tip is responsible for the symmetry and periodicity of the cone cracks. These results provide a better understanding of the fracture processes in soft and brittle materials and open a promising perspective in needle designs and the control of tissue damages during surgical operations.

A novel material point method (MPM) based needle-tissue interaction model

Needle-tissue interaction model is essential to tissue deformation prediction, interaction force analysis and needle path planning system. Traditional FEM based needle-tissue interaction model would encounter mesh distortion or continuous mesh subdivision in dealing with penetration, in which the computational instability and poor accuracy could be introduced. In this work, a novel material point method (MPM) is applied to establish the needle-tissue interaction model which is suitable to handle the discontinuous penetration problem. By integrating a hyperelastic material model, the tissue deformation and interaction force can be solved simultaneously and independently. A testbed of needle insertion into a Polyvinyl alcohol (PVA) hydrogel phantom was constructed to validate both tissue deformation and interaction force. The results showed the experimental data agrees well with the simulation results of the proposed model.

An adaptive finite element model for steerable needles

Penetration of a flexible and steerable needle into a soft target material is a complex problem to be modelled, involving several mechanical challenges. In the present paper, an adaptive finite element algorithm is developed to simulate the penetration of a steerable needle in brain-like gelatine material, where the penetration path is not predetermined. The geometry of the needle tip induces asymmetric tractions along the tool–substrate frictional interfaces, generating a bending action on the needle in addition to combined normal and shear loading in the region where fracture takes place during penetration. The fracture process is described by a cohesive zone model, and the direction of crack propagation is determined by the distribution of strain energy density in the tissue surrounding the tip. Simulation results of deep needle penetration for a programmable bevel-tip needle design, where steering can be controlled by changing the offset between interlocked needle segments, are mainly discussed in terms of penetration force versus displacement along with a detailed description of the needle tip trajectories. It is shown that such results are strongly dependent on the relative stiffness of needle and tissue and on the tip offset. The simulated relationship between programmable bevel offset and needle curvature is found to be approximately linear, confirming empirical results derived experimentally in a previous work. The proposed model enables a detailed analysis of the tool–tissue interactions during needle penetration, providing a reliable means to optimise the design of surgical catheters and aid pre-operative planning.

Influence of a Biocompatible Hydrophilic Needle Surface Coating on a Puncture Biopsy Process for Biomedical Applications

A puncture biopsy is a widely used, minimally invasive surgery process. During the needle insertion process, the needle body is always in direct contact with a biological soft tissue. Tissue adhesion and different degrees of tissue damage occur frequently. Optimization of the needle surface, and especially the lubrication of the needle surface, can deal with these problems efficiently. Therefore, in this paper, a biocompatible hydrophilic coating was applied onto the surface of a needle to improve the surface quality of the needle surface. Further, a simplified finite element model of insertion was established, and extracorporeal insertion experiments were used to verify the accuracy of the model. Then, by analyzing a simulation model of a coated needle and a conventional needle, the influence of the application of the coated needle on the insertion process was obtained. It can be seen from the results that the coating application relieved the force on the needle and the soft tissue during the insertion process and could significantly reduce friction during the insertion process. At the same time, the deformation of biological soft tissue was reduced, and the adhesion situation between the needle and tissue improved, which optimized the puncture needle.

Mechanism of material removal in orthogonal cutting of cortical bone

ANALYSIS

of a mechanism of bone cutting has an important theoretical and practical significance for orthopaedic surgeries. In this study, the mechanism of material removal in orthogonal cutting of cortical bone is investigated. Chip morphology and crack propagation in cortical bone for various cutting directions and depth-of-cut (DOC) levels are analysed, with consideration of microstructural and sub-microstructural features and material anisotropy. Effects of different material properties of osteons, interstitial matrix and cement lines on chip morphology and crack propagation are elucidated for different cutting directions. This study revealed that differences in chip morphology for various DOCs were due to comparable sizes of the osteons, lamellae and DOC. Acquired force signals and recorded high-speed videos revealed the reasons of fluctuations of dynamic components in tests. Meanwhile, a frequency-domain analysis of force signals showed a frequency difference between formation of a bulk fractured chip and small debris for different cutting directions. In addition, SEM images of the top and side surfaces of the machined bone were obtained. Thus, the analysis of the cutting force and surface damage validated the character of chip formation and explained the material-removal mechanism. This study reveals the mechanism of chip formation in the orthogonal cutting of the cortical bone, demonstrating importance of the correlation between the chip morphologies, the depth of cut and the microstructure and sub-microstructure of the cortical bone. For the first time, it assessed the fluctuations of cutting forces, accompanying chip formation, in time and frequency domains. These findings provide fundamental information important for analysis of cutting-induced damage of the bone tissue, optimization of the cutting process and clinical applications of orthopaedic instruments.

The influence of the chosen in vitro bone simulation model on intraosseous temperatures and drilling times

There is no consensus about the most suitable in vitro simulating material investigating heat generation during bone preparation. The aim was to compare heat increases and drilling times of bone removals in different bone simulating materials and to compare them to fresh human cadaver bone. A cavity was drilled in the following samples: (1) bovine rib; (2) pig rib; (3) 20 PCF (lb/ft³) polyurethane (PU) block with 3 mm (50 PCF) cortical layer; (4) 20PCF PU without cortical; (5) 30 PCF PU with 2 mm (40 PCF) cortical; (6) 30 PCF PU with 1 mm (40 PCF) cortical; (7) 30PCF PU without cortical; (8) poly-methyl-methacrylate (PMMA); (9) fresh human cadaver rib. Data were analyzed with ANOVA followed by Tukey’s post hoc tests. P < 0.05 was considered significant. Highest heat increases and slowest drilling times were found in bovine ribs (p < 0.001). Regarding temperatures, human ribs were comparable to the pig rib and to PUs having cortical layers. Considering drilling times, the human rib was only comparable to the 20 PCF PU with 3 mm cortical and to 30 PCF PU without cortical. By the tested in vitro bone removals, only the 20 PCF PU with 3 mm cortical was able to simulate human ribs, considering both temperature increases and drilling times.

Comparative Analysis of the Chemical Composition and Microstructure Conformation Between Different Dental Implant Bone Drills

Background: Hardness is considered an important parameter for evaluating the clinical performance of dental implant bone drills. It is connected to the chemical composition, microstructure conformation and manufacture of the surgical drills. Methods: Microstructure of five dental implant drills using scanning electronic microscopy (SEM) integrated with energy dispersive X-ray spectrometry. Vickers microhardness was measured using a CV 2000 microhardness tester with an indentation force of 500 g. Results: Composition of the implant drills was typical of martensitic stainless steel (MSS). The drills contained 13%–17% of Cr; Mo, Si and Mn were present as minor ligands. The examined bone drills showed different external surface conformation and hardness in relation to the different industrial production processes. A rougher external surface and a higher hardness value are characteristics of the surgical bone drills produced by hot forming; the implant drills produced by machining showed mailing lines on their external surface and a lower hardness. Conclusions: Different compositions and treatments were used by the manufacturers to improve the hardness of the external layer of the dental implant drills making them prone to a diverse heat generation during the implant site preparation.

Finite Element Modeling of Orthogonal Machining of Brittle Materials Using an Embedded Cohesive Element Mesh

Machining of brittle materials is common in the manufacturing industry, but few modeling techniques are available to predict materials’ behavior in response to the cutting tool. The paper presents a fracture-based finite element model, named embedded cohesive zone–finite element method (ECZ–FEM). In ECZ–FEM, a network of cohesive zone (CZ) elements are embedded in the material body with regular elements to capture multiple randomized cracks during a cutting process. The CZ element is defined by the fracture energy and a scaling factor to control material ductility and chip behavior. The model is validated by an experimental study in terms of chip formation and cutting force with two different brittle materials and depths of cut. The results show that ECZ–FEM can capture various chip forms, such as dusty debris, irregular chips, and unstable crack propagation seen in the experimental cases. For the cutting force, the model can predict the relative difference among the experimental cases, but the force value is higher by 30–50%. The ECZ–FEM has demonstrated the feasibility of brittle cutting simulation with some limitations applied.