A supplemental screw enhances the biomechanical stability in medial open-wedge high tibial osteotomy

Autor: Oscar K. Lee, Cheng Fong Chen, Pei Yuan Lee, Chia Ming Chang, Philipp Lobenhoffer, Hsiu Chen Lin, Jesse Chieh Szu Yang, Hsuan Hsiao Ma
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Critical Care and Emergency Medicine
Medical Implants
Knees
Bone Screws
Cannulation
Knee Joints
Stiffness
High tibial osteotomy
Skeletal Joints
Medicine and Health Sciences
Biomechanics
Musculoskeletal System
Trauma Medicine
Orthodontics
Multidisciplinary
Bone and Joint Mechanics
musculoskeletal system
Biomechanical Phenomena
Osteotomy
Bone Fracture
Physical Sciences
Medicine
Legs
Engineering and Technology
medicine.symptom
Anatomy
Traumatic Injury
Research Article
Biotechnology
musculoskeletal diseases
Materials science
Science
Materials Science
Material Properties
Hinge
Surgical and Invasive Medical Procedures
Bioengineering
Models
Biological
Dynamic load testing
Open wedge
medicine
Mechanical Properties
Humans
Tibia
Compressive stiffness
Skeleton
Varus deformity
Biology and Life Sciences
medicine.disease
Tibial Fractures
Body Limbs
Medical Devices and Equipment
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 12, p e0244557 (2020)
ISSN: 1932-6203
Popis: BackgroundThe supplemental screw technique was introduced for salvage of lateral hinge fracture in medial open-wedge high tibial osteotomy (owHTO). The efficacy of its use in protection of lateral hinge fracture and corresponding biomechanical behaviors remained unclear. The current study was aimed to clarify if a supplemental screw can provide better protection to lateral hinge in biomechanical perspective.MaterialsAn in vitro biomechanical test was conducted. Tibial sawbones, commercial owHTO plates and a cannulated screw were utilized for preparing the intact, owHTO, and owHTO with cannulated screw insertion specimens. A “staircase” dynamic load protocol was adopted for axial compressive test with increasing load levels to determine structural strength and durability by using a material testing system, while a motion capture system was applied for determining the dynamic changes in varus angle and posterior slope of the tibia plateau with various specimen preparation conditions.ResultsType II lateral hinge fracture were the major failure pattern in all specimens prepared with owHTO. The insertion of a supplemental cannulated screw in medial owHTO specimens reinforced structural stability and durability in dynamic cyclic loading tests: the compressive stiffness increased to 58.9–62.2% of an intact specimen, whereas the owHTO specimens provided only 23.7–29.2% of stiffness of an intact specimen. In view of tibial plateau alignment, the insertion of a supplemental screw improved the structural deficiency caused by owHTO, and reduced the posterior slope increase and excessive varus deformity by 81.8% and 83.2%, respectively.ConclusionThe current study revealed that supplemental screw insertion is a simple and effective technique to improve the structural stability and durability in medial owHTO.
Databáze: OpenAIRE
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