In North America and three European countries translational medicine (TM) funding has taken center stage as the National Institutes of Health (NIH), for example, has come to recognize that delays are commonplace in completing clinical trials based on benchside advancements. Recently, there are several illustrative examples whereby the translation of research had untoward outcomes requiring immediate action. Focus more on three-dimensional (3D) simulation, biomarkers, and artificial intelligence may allow orthopaedic surgeons to predict the ideal practices before orthopaedic surgery. Using the best medical imaging techniques may improve the accuracy and precision of tumor resections. This article is directed at young surgeon scientists and in particular orthopaedic residents and all other junior physicians in training to help them better understand TM and position themselves on career paths and hospital systems that strive for optimal TM. It serves to hasten the movement of knowledge garnered from the benchside and move it quickly to the bedside. Communication is ongoing in a bidirectional format. It is anticipated that more and more medical centers and institutions will adopt TM models of healthcare delivery.
10 May 2019 in Current Medical Research and Opinion
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. Materials and 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 are discussed and highlighted that lead to thermal necrosis. 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.