Research Proposal: Investigation into the Use of Laser Tools in Orthopaedic Surgery

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The desire for tighter manufacture tolerances have seen substantial progress in laser ablationprecision, most recently through shifts to femtosecond ultrashort pulse lasers. The reduction inlocalised heating from such equipment has enabled greater precision and reduced microstructuredamage, by dispersing energy throughout the material in both thermal and electron diffusion (He etal., 2015). Sub-micrometre precision has been observed in the ablation of metals, semiconductors,crystals, glasses and ceramics, inspiring potential for their use in bone ablation (Wang et al., 2015).The greatest risk from such surgical application is that of fracture through high thermal-inducedstresses in the brittle material; it is therefore imperative that this localised heating reduction carriesover to use in live bone tissue. The opportunities offered by orthopaedic laser surgery are commonwith other operations; laser ablation enables precision, operative ease and cauterisation of damagedvessels, consequently promising increased surgical capabilities and improved patient recovery.This proposal describes numerous opportunities for studying this process and the potentialimplementation of femtosecond laser ablation in orthopaedic surgery. The first gauge of suitabilitywould come through the modelling of heat generation at the bone surface, resultant from variouspulse durations: nano-, pico- and femtosecond. This primary investigation would offer clarity to theeffect of localised and overall heating on deformation and mechanical failure, from which arelationship between pulse duration, power and mechanical integrity could be established.Presuming a satisfactory simulation outcome, further investigations would provide correlationbetween beam intensity and bone density, indicating the suitability of the method in a variety oflocations and patient conditions.With heating analysed, the next computation would investigate appropriate cutting surfaces. Lasersurgery can be either direct, where the laser radiation directly processes the tissue; or indirect,where radiation modified the tissue through heating a coated tip attached to the end of the opticalfibre, a heated scalpel (Bredikhin et al., 2016). Appropriate cutting surfaces would be compared,through modelling, before laboratory investigations are conducted.With modelling phases complete, laboratory testing would follow; primary investigations would testthe laser on biological tissues. With small tissue samples tested, investigations into larger deadtissue would be conducted. For reliable testing, primary bone ablation would be assisted with saline Joseph Burnford 14/08/2020flow throughout the material, replicating the thermal transport afforded by blood flow in livingtissue. With procedures iteratively modified and remodelled, as the test subject becomes closer toliving tissue, a final non-clinical test, with donations from the recently deceased, would beconducted. If all testing phases are successful and ethical approval is acquired, there may be anopportunity for the procedural testing to be finalised through clinical trial.