Systems and methods for bone cement removal using real-time acoustic feedback, such as during a drilling process in a revision arthroplasty, are discussed. A system for bone cement removal may include a processor (116) to perform operation comprising receiving digital frequency data from the microphone (106), comparing at least a portion of the digital frequency data to a plurality of frequency signatures, determining, based at least in part on the comparing, whether the portion of the digital frequency data is representative of a cut bone frequency or a cut bone cement frequency, and adjust or not a control parameter of a drill or other cutting tool (110) in response.
