{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:25:27Z","timestamp":1787030727907,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":228,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advances in Orthopedics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Aseptic loosening after total knee arthroplasty (TKA) can follow thermal bone injury produced by power tools. This study compared the intraoperative bone temperatures generated by rotary burrs used in robotic\u2010assisted TKA (rTKA) with those from oscillating saws used in conventional TKA (cTKA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010centre observational trial employed infrared thermography (30\u2009Hz, \u00b10.05\u00b0C) to record surface temperatures during the distal femoral cut in 14 primary TKAs (rTKA\u2009=\u20096, cTKA\u2009=\u20098). Burr cuts used a 6\u2010mm spherical burr at 80,000\u2009rpm; saw cuts used Stryker sagittal blades. Peak and mean temperatures and the time spent above 47\u00b0C, 56\u00b0C and 70\u00b0C were extracted from the recordings and compared with Mann\u2013Whitney tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All procedures exceeded the osteonecrosis threshold (47\u00b0C); maximal temperatures surpassed 90\u00b0C in every burr case and in 5\/8 saw cases. Median cutting time was 241\u2009s with the burr versus 26\u2009s with the saw (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). The bone remained above 47\u00b0C for a median 107\u2009s (IQR 138) with the burr, nearly four\u2010fold longer than with the saw (8\u2009s; IQR 10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Similar differences were observed above 56\u00b0C (65\u2009s vs. 3\u2009s) and 70\u00b0C (15\u2009s vs. 0.5\u2009s). Mean temperatures (\u223c51\u00b0C) did not differ significantly between devices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rotary burrs and oscillating saws both generate potentially harmful heat during TKA, but burrs markedly prolong exposure to cytotoxic temperatures and lengthen operative time. These findings suggest a higher theoretical risk of thermally mediated bone injury and subsequent implant loosening when burrs are used without active cooling. Larger controlled studies should assess mitigation strategies such as irrigation, cooled instrumentation or modified cutting protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/aort\/4182322","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:18Z","timestamp":1787027358000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thermal Effects of Burr and Saw Cutting Tools in Total Knee 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