Biomechanical Stability of Open-Wedge High Tibial Osteotomy: Comparison of Two Locking Plates

DOI: 10.4236/ojo.2014.410042   PDF   HTML   XML   3,215 Downloads   4,232 Views   Citations

Abstract

Introduction: Recently, new plates with locking screws have been developed and used for medial open-wedge high tibial osteotomy (HTO). The purpose of this study was to evaluate and compare biomechanical properties of different internal fixations in open-wedge HTO using the two currently available locking plates. Methods: Eight paired fresh-frozen cadaveric lower extremities were vertically embedded in steel boxes. The axial compression load was applied to the legs using the mechanical testing machine. The axial compression load test from 0 N to 550 N and the failure test were performed before and after HTO. One side of the leg of a specimen was fixed with the Puddu locking plate and the other side was fixed with the TomoFix plate to compare the two plates using the same specimen. A mode of failure and vertical displacement of the medial and lateral parts of the tibia at the osteotomy gap was recorded using a video camera in the failure test. The load–displacement data were analyzed to calculate stiffness, failure load, and displacement at failure. Results: The mean failure load was 1471.4 N and 1692.3 N and total vertical displacement at failure was 3.1 mm and 2.9 mm with the Puddu and TomoFix plates, respectively. During axial compression loading, displacements mainly occurred at the lateral osteotomy gap, while the medial gap was well preserved. No significant differences were observed in the failure load, displacement, or mode of failure between the two plates. Conclusions: The Puddu and TomoFix plates had similar biomechanical properties in open-wedge HTO. The results indicated reliable stability after open-wedge HTO without fibular osteotomy.

Share and Cite:

Watanabe, K. , Kamiya, T. , Suzuki, D. , Otsubo, H. , Teramoto, A. , Suzuki, T. and Yamashita, T. (2014) Biomechanical Stability of Open-Wedge High Tibial Osteotomy: Comparison of Two Locking Plates. Open Journal of Orthopedics, 4, 257-262. doi: 10.4236/ojo.2014.410042.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Floerkemeier, S., Staubli, A.E., Schroeter, S., Goldhahn, S. and Lobenhoffer, P. (2013) Outcome after High Tibial Open-Wedge Osteotomy: A Retrospective Evaluation of 533 Patients. Knee Surgery, Sports Traumatology, Arthroscopy, 21, 170-180.
http://dx.doi.org/10.1007/s00167-012-2087-2
[2] Maffulli, N., Loppini, M., Longo, U.G., Denaro V. and Oliva, F. (2013) Bovine Xenograft Locking Puddu Plate versus Tricalcium Phosphate Spacer Non-Locking Puddu Plate in Opening-Wedge High Tibial Osteotomy: A Prospective Double-Cohort Study. International Orthopaedics, 37, 819-826.
http://dx.doi.org/10.1007/s00264-013-1817-5
[3] Noyes, F.R., Mayfield, W., Barber-Westin, S.D., Albright, J.C. and Heckmann, T.P. (2006) Opening Wedge High Tibial Osteotomy. American Journal of Sports Medicine, 34, 1262-1273.
http://dx.doi.org/10.1177/0363546505286144
[4] Nelissen, E.M., van Langelaan, E.J. and Nelissen, R.G. (2010) Stability of Medial Opening Wedge High Tibial Osteotomy: A Failure Analysis. International Orthopaedics, 34, 217-223.
http://dx.doi.org/10.1007/s00264-013-1817-5
[5] Agneskirchner, J.D., Freiling, D., Hurschler, C. and Lobenhoffer, P. (2006) Primary Stability of Four Different Implants for Opening Wedge High Tibial Osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy, 14, 291-300.
http://dx.doi.org/10.1007/s00167-005-0690-1
[6] Pape, D., Lorbach, O.L., Schmitz, C., Busch, L.C., van Giffen, N., Seil, R. and Kohn, D.M. (2010) Effect of a Biplanar Osteotomy on Primary Stability Following High Tibial Osteotomy: A Biomechanical Cadaver Study. Knee Surgery, Sports Traumatology, Arthroscopy, 18, 204-211.
http://dx.doi.org/10.1007/s00167-009-0929-3
[7] Spahn, G., Mückley, T., Kahl, E. and Hofmann, G.O. (2006) Biomechanical Investigation of Different Internal Fixations in Medial Opening-Wedge High Tibial Osteotomy. Clinical Biomechanics, 21, 272-278.
http://dx.doi.org/10.1016/j.clinbiomech.2005.10.010

  
comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.