Milling versus Sawing: Comparison of Temperature Elevation and Clinical Performance During Bone Cutting

A fundamental requirement for the success of an implant process is the quality of bone resection, mainly related to temperature elevation during cutting and to the accuracy of the resection. Existing surgical saws have largely been investigated, but appear still unable to maintain the temperature elevation within acceptable parameters. In this paper we analyse an alternative approach to realising large bone resections, studying the performance of the milling technique. The temperature elevation during milling is carefully analysed with different surgical tools, and an overall estimation of the accuracy and usability of this technique is discussed. The results of this study prove that milling can be used without the need for cooling procedures (T < 46°C), within an acceptable surgical time (~ 4 min for knee resections) , and with negligible fatigue to the user.