A synthetic bone insert may protect the lateral cortex and fixation plate following a high tibial osteotomy by reducing the tensile strains
| Autor: | Jack Farr, Rachel MacDonald, Cynthia E. Dunning, Timothy A. Burkhart, Kyla Huebner, Alan M. Getgood |
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| Rok vydání: | 2019 |
| Předmět: |
business.product_category
Compressive Strength Knee Joint medicine.medical_treatment Osteotomy Wedge Strain 03 medical and health sciences Fixation (surgical) 0302 clinical medicine High tibial osteotomy Tensile Strength Ultimate tensile strength Absorbable Implants Medicine and Health Sciences Cadaver Cortical Bone Medicine Humans Orthopedics and Sports Medicine Strain gauge Aged Aged 80 and over 030222 orthopedics Tibia business.industry Synthetic bone 030229 sport sciences Middle Aged Fixation Wedge (mechanical device) Fracture Surgery business Cadaveric spasm Stability Bone Plates Biomedical engineering |
| Zdroj: | Bone and Joint Institute |
| ISSN: | 1433-7347 |
| Popis: | © 2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA). Purpose: To determine the effectiveness of a synthetic bone insert on improving medial opening wedge high tibial osteotomy integrity in response to post-surgical cyclical loading. Materials and methods: A medial opening wedge high tibial osteotomy, secured with a compression fixation plate, was performed on 12 cadaveric knee specimens that were randomised to either: (1) a synthetic insert condition (n = 6), in which a 9 mm bio-absorbable wedge was inserted into the gap space; or (2) a plate-only condition (n = 6). Uniaxial strain gauges, placed on the lateral cortex and fixation plate, measured the strain response as the specimens were subjected to a staircase cyclical loading protocol; a sinusoidal waveform between 100 and 800 N was applied and increased by increments of 200 N every 5000 cycles until failure. Peak strains at failure were compared between conditions using a one-tailed independent samples t test. Results: The strains from the fixation plate were significantly different between the insert and plate only conditions (p = 0.02), transitioning from a compressive strain with the wedge (mean [SD] = − 8.6 [− 3.6] µε) to a tensile strain without the wedge (mean [SD] = 12.9 [23] µε). The strains measured at the lateral cortex were also significantly affected by the inclusion of a synthetic bone insert (p = 0.016), increasing from − 55.6 (− 54.3) µε when the insert was utilised to 23.7 (55.7) µε when only the plate was used. Conclusions: The addition of a synthetic insert limited the tensile strains at the plate and lateral cortex, suggesting that this may protect these regions from fracture during prolonged loading. |
| Databáze: | OpenAIRE |
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