Optimizing bone screw insertion: The impact of pre-drilling diameter,bone quality,and spindle speed on mechanical stability and thermal dynamics in synthetic models
Restricted accessResearch articleFirst published online June, 2025
Optimizing bone screw insertion: The impact of pre-drilling diameter,bone quality,and spindle speed on mechanical stability and thermal dynamics in synthetic models
In orthopedic surgery, proper bone screw fixation is paramount to ensure patient recovery. However, complications like screw loosening, bone fracture, or poor fixation can arise from inappropriate insertion protocols. This study aims to determine the optimal pre-drilling diameter for secure screw fixation while minimizing thermal damage and mechanical failure in orthopedic procedures. Through comprehensive experimentation on synthetic bone coupons simulating normal and osteoporotic bones, we investigated the influence of pre-drilling diameter, bone density, and insertion velocity on bone screw fixation. A study measured temperature at the insertion site, insertion torque, and pull-out strength. Our study found that the pre-drilling diameter is pivotally important to the thermal dynamics and mechanical stability of screw insertion. Smaller diameters in synthetic bone coupons generate higher temperatures due to increased friction and diminished heat dissipation, exacerbated by higher spindle speeds. Bone screw insertion torque displays a predictable three-phase behavior, reaching peak levels at cortical engagement and reducing in cancellous bone. Additionally, smaller hole diameters necessitate increased torque during insertion. Pull-out tests demonstrated that screws placed in smaller pre-drilled holes bear more robust fixation. However, smaller diameters also resulted in potential synthetic bone surface damage during extraction. This study emphasizes the critical nature of optimizing pre-drilling diameter to achieve a successful balance between secure screw fixation and low insertion torque. Accommodating the variable bone qualities and operational conditions are essential to minimize the risk of thermal damage and mechanical failure. Future clinical guidelines derived from these findings could lead to enhanced patient outcomes after orthopedic procedures requiring bone screws.
YerbySScottCCEvansNJ, et al. Effect of cutting flute design on cortical bone screw insertion torque and pullout strength. J Orthop Trauma2001; 15(3): 216–221.
2.
ÇetinABircanDA.Experimental investigation of pull-out performance of pedicle screws at different polyurethane (PU) foam densities. Proc IMechE, Part H: J Engineering in Medicine2021; 235(6): 709–716.
3.
DemirTCamuşcuNTüreyenK.Design and biomechanical testing of pedicle screw for osteoporotic incidents. Proc IMechE, Part H: J Engineering in Medicine2012; 226(3): 256–262.
4.
HeinemannFHasanIBourauelC, et al. Bone stability around dental implants: treatment related factors. Ann Anat2015; 199: 3–8.
5.
SilvaGAFFaotFPossebonAPDR, et al. Effect of microgeometry and bone type on insertion torque, primary stability, surface topography damage and titanium release of dental implants during surgical insertion into artificial bone. J Mech Behav Biomed Mater2021; 119: 104515.
6.
ArslanAKDemirTÖrmeciMF, et al. Postfusion pullout strength comparison of a novel pedicle screw with classical pedicle screws on synthetic foams. Proc IMechE, Part H: J Engineering in Medicine2013; 227(2): 114–119.
7.
BennieSCrowleyJDWangT, et al. Pedicle screw pull-out testing in polyurethane foam blocks: effect of block orientation and density. Proc IMechE, Part H: J Engineering in Medicine2024; 238(4): 455–460.
8.
GholampourSHassanalidehHHGholampourM, et al. Thermal and physical damage in skull base drilling using gas cooling modes: FEM simulation and experimental evaluation. Comput Methods Programs Biomed2021; 212: 106463.
9.
ShuLLiSTerashimaM, et al. A novel self-centring drill bit design for low-trauma bone drilling. Int J Mach Tools Manuf2020; 154: 103568.
10.
ZhangYXuLWangC, et al. Mechanical and thermal damage in cortical bone drilling in vivo. Proc IMechE, Part H: J Engineering in Medicine2019; 233(6): 621–635.
11.
Robles-LinaresJAAxinteDLiaoZ, et al. Machining-induced thermal damage in cortical bone: necrosis and micro-mechanical integrity. Mater Des2021; 197: 109215.
12.
TawyGFRowePJRichesPE.Thermal damage done to bone by burring and sawing with and without irrigation in knee arthroplasty. J Arthroplasty2016; 31(5): 1102–1108.
13.
HelitoCPBonadioMBDemangeMK, et al. Screw loosening and iliotibial band friction after posterolateral corner reconstruction. Knee2014; 21(3): 769–773.
14.
GalbuseraFVolkheimerDReitmaierS, et al. Pedicle screw loosening: a clinically relevant complication?Eur Spine J2015; 24(5): 1005–1016.
15.
MoroniAFaldiniCPegreffiF, et al. HA-coated screws decrease the incidence of fixation failure in osteoporotic trochanteric fractures. Clin Orthop Relat Res2004; 425(425): 87–92.
16.
El SamanAMeierSSanderA, et al. Reduced loosening rate and loss of correction following posterior stabilization with or without PMMA augmentation of pedicle screws in vertebral fractures in the elderly. Eur J Trauma Emerg Surg2013; 39(5): 455–460.
17.
MatthewsLSHirschCARL. Temperatures measured in human cortical bone when drilling. J Bone Joint Surg1972; 54(2): 297–308.
18.
AbouzgiaMBJamesDF.Temperature rise during drilling through bone. Int J Oral Maxillofac Implants1997; 12(3): 342–353.
19.
PiattelliAPiattelliMManganoC, et al. A histologic evaluation of eight cases of failed dental implants: is bone overheating the most probable cause?Biomaterials1998; 19(7–9): 683–690.
20.
BassiJLPankajMNavdeepS.A technique for removal of broken cannulated drill bit: Bassi’s method. J Orthop Trauma2008; 22(1): 56–58.
21.
PriceMVMolloySSolanMC, et al. The rate of instrument breakage during orthopaedic procedures. Int Orthop2002; 26(3): 185–187.
22.
PichlerWMazzuranaPClementH, et al. Frequency of instrument breakage during orthopaedic procedures and its effects on patients. J Bone Joint Surg Am2008; 90(12): 2652–2654.
23.
SneathRS.The determination of optimum twist drill shape for bone. In: KenediRM (ed.) Biomechanics and related bio-engineering topics. Glasgow: Elsevier, 1965, pp.41–45.
24.
AcciniFDíazIGilJJ, et al. Using an admittance algorithm for bone drilling procedures. Comput Methods Programs Biomed2016; 123: 150–158.
25.
DíazIGilJJLouredoM, et al. Bone drilling methodology and tool based on position measurements. Comput Methods Programs Biomed2013; 112(2): 284–292.
26.
SuiJSugitaN.Experimental study of thrust force and torque for drilling cortical bone. Ann Biomed Eng2019; 47(3): 802–812.
27.
MöhlhenrichSCHeussenNModabberA, et al. Influence of bone density, screw size and surgical procedure on orthodontic mini-implant placement–part A: temperature development. Int J Oral Maxillofac Surg2021; 50(4): 555–564.
28.
FernandesMGFonsecaEMMJorgeRN, et al. Thermal analysis in drilling of ex vivo bovine bones. J Mech Med Biol2017; 17(5): 1750082.
29.
FernandesMGFonsecaEMJorgeRN.Thermo-mechanical stresses distribution on bone drilling: numerical and experimental procedures. Proc IMechE, Part L: J Materials Design and Applications2019; 233(4): 637–646.
30.
FernandesMGAFonsecaEMMNatalRJ. Thermal analysis during bone drilling using rigid polyurethane foams: numerical and experimental methodologies. J Braz Soc Mech Sci Eng2016; 38(7): 1855–1863.
31.
FernandesMGFonsecaEMMJorgeRN, et al. Ex vivo experimental and numerical study of stresses distribution in human cadaveric tibiae. Int J Med Eng Inform2021; 13(2): 164–173.
32.
WillsDJPrasadAGilmerBB, et al. The thermal profile of self-tapping screws: the effect of insertion speed, power insertion, and screw geometry on heat production at the bone-screw interface. Med Eng Phys2020; 100: 103754.
33.
AgarwalRGuptaVSinghJ.Mechanical and biological behavior of additive manufactured biomimetic biodegradable orthopedic cortical screws. Rapid Prototyp J2022; 28(9): 1690–1705.
34.
SinghNSinghG.Advances in polymers for bio-additive manufacturing: a state of art review. J Manuf Process2021; 72: 439–457.
35.
SinghRPGuptaVPandeyPM, et al. Effect of drilling techniques on microcracks and pull-out strength of cortical screw fixed in human tibia: an in-vitro study. Ann Biomed Eng2021; 49(1): 382–393.
36.
VafadarSRouhiG.The effects of geometrical parameters of the pedicle screw on its pullout strength: In-vitro animal tests. Journal of Orthopedic and Spine Trauma2017; 3: 14789.
37.
VargheseVRamuPKrishnanV, et al. Pull out strength calculator for pedicle screws using a surrogate ensemble approach. Comput Methods Programs Biomed2016; 137: 11–22.
38.
AgarwalRGuptaVSinghJ.Leveraging ultrasonic actuation during inclined orthopedic bone drilling: an experimental and histological study. Appl Acoust2023; 211: 109520.
39.
MirzaieTRouhiGMehdi DehghanM, et al. Dental implants’ stability dependence on rotational speed and feed-rate of drilling: in-vivo and ex-vivo investigations. J Biomech2021; 127: 110696.
40.
SzivekJAThomasMBenjaminJB.Characterization of a synthetic foam as a model for human cancellous bone. J Appl Biomater1993; 4(3): 269–272.
41.
ChatzistergosPEMagnissalisEAKourkoulisSK.Numerical simulation of bone screw induced pretension: the cases of under-tapping and conical profile. Med Eng Phys2014; 36(3): 378–386.
42.
KimYYChoiWSRhyuKW.Assessment of pedicle screw pullout strength based on various screw designs and bone densities—an ex vivo biomechanical study. Spine J2012; 12(2): 164–168.
43.
TsujiMCrookshankMOlsenM, et al. The biomechanical effect of artificial and human bone density on stopping and stripping torque during screw insertion. J Mech Behav Biomed Mater2013; 22: 146–156.
44.
BattulaSSchoenfeldAVrabecG, et al. Experimental evaluation of the holding power/stiffness of the self-tapping bone screws in normal and osteoporotic bone material. Clin Biomech2006; 21(5): 533–537.
45.
PawarSJoshiSS.Experimental analysis of axial and torsional vibrations assisted tapping of titanium alloy. J Manuf Process2016; 22: 7–20.
46.
HuangYLvBShiP.Weight determination method based on improved grey relational degree. J Wuhan Univ Sci Technol2004; 3: 72–75.
