SMARTdrill® technology provides intricate control and feedback to help surgeons optimize drill bit performance and avoid thermal damage.
DRILL BIT CLOGGING
SMARTdrill® technology provides intricate control and feedback that allows surgeons to optimize drill bit performance and avoid thermal damage to bone and surrounding tissues. SMARTdrill® alerts the surgeon of impending temperature spikes that can cause thermal necrosis. For example, in the Drill Bit Clogging picture, the surgeon is drilling a bi-cortical block, the torque should be flat between the two cortices. The slow rise after the first cortex indicates flute clogging. The extra torque is not doing work, instead it is being lost as heat, thus heating up the bone. This type of instantaneous information allows the surgeon to make a correction in a timely manner, for example before trying to drill the far cortex with a clogged bit and before any tissue damage is done.1 This is of major importance because dead bone loses pullout strength and can be easily colonized by bacteria. Loss of fixation and life and limb threatening infection can result. From a biological perspective, bone is a living tissue that does not tolerate heat well. Physicians have always been taught to avoid harm to the patient. Specifically, surgeons train to be minimally invasive and tissue friendly. Now, surgeons have a powerful tool, the SMARTdrill®, to facilitate the teachings, and the oath, to “First, do no harm”. With standard bone drills the surgeon must rely on auditory and tactile feedback combined with training and experience to find a balance between drilling too fast which results in increased plunge and drilling too slow which results in burn. A recent article by Karacas2 summarizes the difficulties surgeons face trying to control multiple factors when drilling bone. Most of these factors are not in the surgeon’s control. The optimal feed rate, RPM or force for optimal drill bit performance for any specific patient is unknown. Also, a surgeon does not know when they are approaching dangerous thermal levels until they see smoke coming from the bone. This is much too late, thermal injury has occurred and osteolysis is assured. It then becomes a race between the bone healing and the subsequent fixation failing due to the the bone being resorbed around the screw (osteolysis). When the construct fails, or the fracture does not heal, complex revision surgery becomes necessary. SMARTdrill® technology provides surgeons with the optimal drill bit*, feed rate, RPM, and force, taking the guesswork out of drilling. SMARTdrill® is the most bone and tissue friendly drill available today.
* Optimal drill bit designs will be available to surgeons with the use of SMARTbenchtop. SMARTbenchtop allows engineers and surgeons to work together to design drill bits that perform optimally in any situation.
The red shaded area in the image above is a ring sequestrum, that is Dead bone caused by severe thermal injury during drilling.1 This bone is no longer viable for securing an implant and may seriously complicate the patient’s recovery.
© 2018 Smart Medical Devices, Inc.