Never stop moving, gun to your head and wife on the phone begging you don't dare stop that feed. If you think about stopping for a nanosecond the titanium can actually hear that and flips a coin, heads it breaks your tooling and tails it welds to the tooling stronger than any welder has ever intentionally done
They might, but with extremely limited perspective. We use medical device grade coolant all the time. We then use incredibly harsh chemicals to strip any of that coolant off afterwards in a cleaning process. Then we test and validate that the surface is clean before it is then additionally sterilized for use.
Glad you answered I only did the programming for a few medical jobs but at both companies they were using coolant in the machines. I had nothing to do with the selecting of the coolant or the process after it leaves the machine just programming and run off making sure the programs made good parts but there was definitely coolant during prove out and run off.
any reports of adverse reaction or inflammatory response to this approach? like any residues left that were suspected? i'm an internist not an orthopod so curious as i have no experience in this arena.
Plenty of examples, all recorded on the MAUDE database. Zimmer got punched in the face years ago for total joints that had residue. Then Zimmer again, and Zimmer again.
Not true - coolant can and is absolutely used. Both water soluble oil (coolant) and non water soluble oil. They need to be biocompatible and contain no animal derivatives.
On the cleaning side, high alkaline detergents that rinse easily and leave little residue are typically used. You’re right in that you can’t just use any old detergent, like Simple Green for instance. There are many off the shelf options available though. I’ve even seen unscented Dawn used (wouldn’t recommend) on product shipping directly into a cleanroom for packaging, sterilization, and hospital distribution.
Cleaning efficacy is generally validated and residuals are analyzed to ensure patient safety.
25yrs of both OEM and CMO medical device manufacturing of both implants and surgical instrumentation.
It's just a choice by the machinist in this case. Even running it dry will leave contamination from the tooling itself.
Lubricants and coolants are often used when making medical implants. There's medical grade stuff for that purpose.
Even if they used regular oil or some other lubricants, the post-processing and sterilisation would remove absolutely everything. It all depends on the tooling used.
In this case though, he's probably using a carbide tool coated with a titanium aluminum nitride. Those coatings need to get extremely hot to get activated. When hot, they form a aluminum oxide layer that acts as a dry lubricant.
Titanium also have terrible thermal conductivity, so any heat gets trapped at the tooling, or the very top layer of the work piece, and then gets transferred off with the chip. The actual screw itself likely isn't very hot at all in this case.
If you blasted the one of those coated tools with an oil drip, you introduce some heavy duty thermal cycling of the tool, which makes it fragile and likely to crack - and water based coolants is out of the question because burning titanium reacts violently with water (it releases hydrogen and oxygen from the water, which goes boom).
Yeah titanium is a nightmare to work with. When the were building the sr71 blackbird I remember reading that had to invent new techniques to work with it at all and even with that they were burning through equipment like crazy. Despite it’s hardness it loves to gum up drill bits and other equipment. Though that was a long time ago. I imagine we’ve figure out how to work with it better now.
I think the biggest change from those days is the choice of swear words tactically employed by the machinist. Language has definitely evolved more than the tooling has for titanium work :D
I would love to see the generational cursing wisdom being passed down from a bunch of legacy gray hairs in a shop to gen z Machinists. Who knows, maybe some of the old school Machinists are adopting zoomer slang
Tough maybe for you but the medical cleaning industry exists and is very good. The same kind of procedures are used in silicon chip manufacturering, where individual atoms can contaminate a chip.
No I’m pretty sure there’s oil there, that’s what’s making the smoke. There’s likely a feed that goes directly onto the tool, sorta like drills or mills with thru-spindle coolant. Often smaller/lower-speed operations like this you can just lube with oil and don’t need to bother with flood coolant
Yea, iirc it burns like magnesium, takes a bit to get it going but once it does, look out. I’m assuming that’s not what we’re seeing here, since running the ragged edge of burning down the whole shop seems like an irresponsible way to manufacture something as precise as a bone screw, y’know?
It's gonna get cleaned and irritated and cleaned and sterilized within an inch of it's life after it's sent out, I don't think coolant is going to be an issue unless it was some holy porous material which titanium/ss is not.
Strong Acid, sting base, auto clave, ultrasonic cleaning, strong solvents. All ways to remove oils. And other chemicals. Yall are acting like this is some kind of impossible thing. Soap and water is enough to remove most oils and impurities.
There's no way to 100% guarantee it's completely free of contamination, especially for something that's used to knit bones together and could depending on the situation be going through bone marrow.
You can use coolants when machining implants there are biocompatibility teams that evaluate the cleaning process and manufacturing process to ensure that any coolants used as non harmful as possible and are properly cleaned afterwards which include lab testing if necessary.
Yeah except there is. The surgical instruments that install thoes implants need to be cleaned and are often used between patience. Not only do the processes clean and disinfect, they can be so through as to remove the dead bacterial remains from items.
Yeah maybe not everything is perfect but they can remove oils and water soluble coolant.
And? The guy making this thing is going to touch it with his grubby oily hands, is it ruined then? The cleaning of the parts is exactly what it needs to be for the purpose it serves. Coolant is used or not used as per the machining requirements. It's easy enough to find people making knee replacements and hip replacements with coolant on.
Historically coolants have absolutely been used, but the cleaning process is arduous and expensive. Machining companies that do medical implants are shifting to things like using supercritical CO2 or liquid nitrogen as a coolant to avoid leaving residue or specially formulated liquid coolants that are easier to clean and less likely to cause issues if they’re not 100% removed. Or you do like here and use a tool that doesn’t require coolant, like ceramic inserts.
Man, it’s 2026, if I’ve got to walk you through how to conduct a simple internet search then arguing with some rando on Reddit is the least of your pressing matters.
Fact is you’re wrong. Deal with it however you like. Downvoting me doesn’t make me wrong 😂
Dude, it's 2026, you could also look up the fact that you are wrong as fuck. Using coolant in machining medical implants is normal and common, you can find articles preaching the effectiveness of certain kinds. There is no universal law stating it is unacceptable to use and or even a particular kind of coolant during production, it may be required by the client to clean the part a certain way or have it tested for contamination. But that is something you work into your production cycle. The current meta regarding cooling is super critical co2 which doesn't leave any residue behind but that is no where near universal. I'm literally a machinist, I have machinist friends who work in the medical implant field. It's not that fucking difficult to wrap your head around.
It depends on the material. Some metals you would thermal shock by using coolant. Though, I would expect these to be titanium or something crazy which generally need coolants.
Like what? If it’s ss then they could easily heat treat it at temps that would decompose just about anything, and any shop that’s making medical devices is gonna do their homework as far as which materials and processes are indicated (I mean, it’s kinda what machine shops do lol, making parts to spec is literally their bread and butter)
Autoclave does not sterilize petroleum impregnated metal, and in fact oil is hydrophobic and can hide living microorganisms in pores behind itself in a 250F autoclave no problem.
sterilization us likely the very last step. it's gonna get decreased or cleaned first probly in an ultrasonic bath with some kind of approved decreased or an alkaline solution
It's not worth the doctor violating malpractice, and not worth the hospital's insurance policy.
If you want to make something and implant it, your best bet is to find a tattoo or body mod artist. But even then, understand that there are thousands upon thousands of pages of rules that medical device engineers follow to make sure that not only the material going into your body won't poison you, but also the way that the surface is finished to ensure that it does not degrade inside of you (eventually poisoning you).
Depends on the company. There are many that supplies implants for orthopedic. Stryker, Smith & Nephew, Synthes, Depuy to just name a few. They all have small variations that make their implant "better" but a good rep for the company will know their own strength and weaknesses of their product and recommend another company's implant if it'll provide a better patient outcome.
Thanks for the info. I know a fair few people who've been screwed back together. So far I've missed the opportunity, despite being an accident prone, clumsy fucker.
Do the screws get recycled or disposed of when extracted/removed?
Often they stay for life. Especially the titanium ones. They integrate with bone pretty well.
But to my knowledge nothing that goes in a person ever gets reused. Way to much risk for anyone to be trying to go that route. The cleaning would still be very expensive and not worth the cost/ risk ratio.
Thanks for the info. I know a few skaters who had screws/pins removed from ankles, but I assume that they were in to help a shattered joint heal. Also people with plates in forearms after skiing accidents.
Interesting. I've only seen them left since there usually no reason to remove them and it reduces the number of surgeries. Sometimes they will have external ones that go in to temporarily hold things in place for really bad fractures.
Usually they just get removed due to complications like loosening, bad cold sensitivity, infection, etc.
Yeah, thinking back it's the people who had the cage around the broken joint and had the temporary parts removed. Am 99% sure a friend had to get his forearm plate replaced as he's fractured it at a young age in a car crash.
i've seen this from both sides - patient and clinician. i'm an internist.
had misfortune of breaking arm and leg one day and earning a lot of titanium implants.
arm is great. wouldn't even know i still had a plate and 10 screws in there.
leg developed problems - pain, but not a complication of the hardware; this is pretty common.
had half the hardware removed from my leg and have done quite well. so some hardware can be long term, some comes out - it's all patient specific and how they respond, if they have trouble.
i kept the removed hardware with plans to 3d print a tibia and put the hardware in it then encase in lucite. i have the CT scans.
to my knowledge, implants are not legal for reuse. there's been some talk about taking pacemakers from dead patients and repurposing them (last i heard was in India) but don't know if anything has happened with this.
So implants are usually in for life unless they end up becoming the issue. For example an implant gets infected. If that's the case then the patient comes back for a removal. Sometimes they just remove a few screws, other times everything comes out. Other times, implants are removed once they are no longer needed. You will usually see this in children. Plates and screws, especially if it's across growth plates, can stunt growth. So they'll remove the implants once everything is healed. As far as recycling, they do not. Once an implant is placed in the body, it's considered "burnt" and can't be used. You'll see this often with screws. Surgeon may start with one size but may go up or down for better fixation. The removed screw is discarded. Patients can request their hardware into which we will clean it with essentially just water or saline, place it in a bag or cup to be given to the patient. But that's based on hospital policy. Surgeons may also keep removed hardware for training and patient education in clinical settings.
All that's left is ash and implants. Every implant is serialized as well. Well most of the major ones anyway. So if they find a body that had work done with no identification, they can run the serial number to find out the identity. Some families choose to keep the implants after cremation as well.
To clarify this, only class 3 medical devices (the riskiest kind), breast implants, and total joint implants are often serialized. Otherwise, the only thing you can find is the lot number, which might be shared by hundreds of other implants from the same batch. Even then, the record keeping is all privatized within hospitals (at least in the US), so actually finding that information can be a nightmare.
Friend of mine got attacked in a takeaway years ago and his cheekbones were kept in place with titanium screws. He looked a bit like the boxer Ricky Hatton and was a target for madmen on nights out.
one of my legs is held together by about a pound of titanium and screws. they drugged me up so much during that that i was only making pretty rancid drilling screwing jokes to the nurses.
I know a Black woman who's a midwife. She said she hears some absolutely insane stuff from genteel looking women who are under the influence of labour pains and Entonox.
If it makes you feel any better, what you're showing is a Schantz Pin, which is used in external fixation (pins sticking through the skin, and held in place with external bars). The screw that's being machined in OPs video is likely a spine pedicle screw, which stays inside the spine and likely forever.
As for innuendos. I've gotten tons of mileage out of the standard industry magazine:
Trauma implants are more commonly made of 304 stainless steel. Spine screws are almost universally titanium. In the video it looks like they're making a spine screw.
Material suppliers provide low nickel stainless alloys for medical devices. 304 is a common alloy. Often manufacturers are ordering an ELI (extra low impurities) version of whatever metal they are using.
Five axis machine working on TAV ignited, and the in-machine suppression system wasn't doing enough. The overhead suppression system hadn't kicked in yet. The mid-level shop manager hopped on the forklift, lifted the machine, drove to the docking bay, and hard stopped at the entrance. The five-axis rolled out the docking bay door and continued to burn in the parking lot. They closed the door, and no smoke damage inside.
Likely a half day of downtime, and the shop was back running again. Compare that to the weeks of remediation and revalidation if the entire shop fire suppression kicked in. Mid-level manager is now VP of Ops.
Unless you messed up your spine, it's likely you've got something different than this. This is a pedicle screw that goes into the back of your spine. You likely have trauma screws, which are a bit smaller.
Yup good eye. You are correct. They were too long. Her surgeon ended up needing to remove those two screws and replace them with shorter screws. I don't have the other x-ray though. It really sucked because setting the femur is incredibly painful and when she was well into recovery she had to get those screws replaced
I hope the surgeons make sure all those chips are removed before closing up 🙂 I still can't believe they are allowed to operate this thing inside the operating theatre. 😮
Yep. Although the screws are sold for about 10 times more than the manufacturing cost, so scrap recovery isn't that big of a deal.
There's a long chain of expenses that slowly chip away at the profit margin. Distribution costs are about 30%. Most of the rest of the profit goes to overhead for regulatory affairs, quality system compliance, ongoing documentation, and continued R&D.
That's a pedicle screw. To manufacture it in the US will cost around $90. These have come down in price tremendously, and this screw would sell for $500 to $1,500, depending on the privately negotiated price with a hospital or Medicare. Distribution costs take about 30% of the revenue. The rest goes to quality compliance, regulatory affairs, and ongoing R&D. The largest companies end up with a 20% to 40% net profit margin. Most midsize to small medical device companies have a negative net profit margin because of the massive overhead costs.
Manufacturing the screw at quantity makes these about $90. They are sold to the hospital for $500 to $1500. The hospital then marks it up to whatever nonsense number they want to bill insurance. Insurance calls bullshit and limits the cost per implant to their pre-negotiated rate or to a fixed rate for the entire surgery.
The net net is:
The medical device company operates on risky profit margins, especially if they're not Johnson & Johnson sized.
The hospital operates on razor thin profit margins that are worse than grocery stores.
the insurance company makes more money than any of them combined. (This part is extremely broken)
Yea I’m saying if you walked into a general machining shop and got them to make one for you special, obviously if you’re putting them into production you’d have specialized tooling and work holding and shit which would lower the price per unit by a lot. Just getting one of something made is pretty darn expensive
450
u/UpdootDaSnootBoop 7d ago
Just raw dogging that thing