BACKGROUND To develop experience, orthopaedic surgeons train their own proprioception to detect torque during screw insertion. This experience is acquired over time and when implanting conventional/non-locked screws in osteopenic cancellous bone the experienced surgeon still strips between 38 and 45%. Technology needs to be investigated to reduce stripping rates. Acoustic-Emission technology has the ability to detect stress wave energy transmitted through a screw during insertion into synthetic bone. Our hypothesis is Acoustic-Emission waves can be detected through standard orthopaedic screwdrivers while advancing screws through purchase and overtightening in cancellous human bone with different bone mineral densities replicating the clinical state. METHODS 77 non-locking 4 mm and 6.5 mm diameter cancellous bone screws were inserted through to stripping into the lateral condylar area of 6 pairs of embalmed distal femurs. Specimens had varying degrees of bone mineral density determined by quantitative CT. Acoustic-Emission energy and axial force were detected for each test. RESULTS The tests showed a significant high correlation between bone mineral density and Acoustic-Emission energy with R = 0.74. A linear regression model with the mean stripping load as the dependent variable and mean Acoustic-Emission energy, bone mineral densities and screw size as the independent variables resulted in r2 = 0.94. INTERPRETATION This experiment succeeded in testing real time Acoustic-Emission monitoring of screw purchase and overtightening in human bone. Acoustic-Emission energy and axial compressive force have positive high correlation to bone mineral density. The purpose is to develop a known technology and apply it to improve the bone-metal construct strength by reducing human error of screw overtightening.

中文翻译：

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使用声发射实时监测螺钉插入可以预测人体松质骨中的螺钉剥离。

背景技术为了积累经验，整形外科医生训练他们自己的本体感觉以在螺钉插入期间检测扭矩。这种经验是随着时间的推移而获得的，当在骨质疏松的松质骨中植入常规/非锁定螺钉时，经验丰富的外科医生仍然会剥掉 38% 到 45% 的骨量。需要研究技术以降低剥离率。声发射技术能够检测在插入合成骨过程中通过螺钉传输的应力波能量。我们的假设是声发射波可以通过标准骨科螺丝刀检测到，同时通过购买和过度拧紧具有不同骨矿物质密度的松质人骨来复制临床状态来推进螺钉。方法 77 非锁定 4 毫米和 6。将直径为 5 mm 的松质骨螺钉插入到 6 对经过防腐处理的远端股骨的外侧髁区域。标本具有不同程度的骨矿物质密度，由定量 CT 确定。每次测试都检测声发射能量和轴向力。结果 测试显示骨矿物质密度与声发射能量之间存在显着的高度相关性，R = 0.74。以平均剥离负荷为因变量，以平均声发射能量、骨矿物质密度和螺钉尺寸为自变量的线性回归模型得出 r2 = 0.94。解释 该实验成功地测试了人体骨骼中螺钉购买和过度拧紧的实时声发射监测。声发射能量和轴向压缩力与骨密度呈正相关。目的是开发一项已知技术并将其应用于通过减少螺钉过紧的人为错误来提高骨金属结构的强度。