An overview of thermal necrosis: present and future

Mohamed Mediouni, Theodore Kucklick, Sébastien Poncet, Riadh Madiouni, Amine Abouaomar, Henning Madry, Magali Cucchiarini, Bohdan Chopko, Neil Vaughan, Manit Arora, Kemal Gökkuş, Mario Lozoya Lara, Lorenlay Paiva Cedeño, Alexander Volosnikov, Mohamed Hesmati, Kevin Ho

    Research output: Contribution to journalReview articlepeer-review

    1 Citation (Scopus)


    Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high-level of heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws. Methods: We searched in the literature for data on parameters that influence drilling bone and could lead to thermal necrosis. The points of view of many orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented. Results: Several potential complications that lead to thermal necrosis are discussed and highlighted. Discussion: Even in the face of growing evidence as to the negative effects of heat induction during drilling, simple and effective methods for monitoring and cooling in real-time are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems and computer simulation techniques. Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.

    Original languageEnglish
    Pages (from-to)1555-1562
    Number of pages8
    JournalCurrent Medical Research and Opinion
    Issue number9
    Early online date10 May 2019
    Publication statusE-pub ahead of print - 10 May 2019


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