Biomechanical properties of five different currently used implants for open-wedge high tibial osteotomy

被引:42
作者
Diffo Kaze A. [1 ]
Maas S. [1 ]
Waldmann D. [1 ]
Zilian A. [1 ]
机构
[1] Technology and Communication, University of Luxembourg, 6, rue R. Coudenhove-Kalergi, Luxembourg
关键词
Biomechanics; ContourLock; Cyclic and static loading; High tibial osteotomy (HTO); iBalance; Mechanical test; Osteoarthritis; PEEKPower; Stiffness; TomoFix; Valgus malrotation;
D O I
10.1186/s40634-015-0030-4
中图分类号
学科分类号
摘要
Background: As several new tibial osteotomy plates recently appeared on the market, the aim of the present study was to compare mechanical static and fatigue strength of three newly designed plates with gold standard plates for the treatment of medial knee joint osteoarthritis. Methods: Sixteen fourth-generation tibial bone composites underwent a medial open-wedge high tibial osteotomy (HTO) according to standard techniques, using five TomoFix standard plates, five PEEKPower plates and six iBalance implants. Static compression load to failure and load-controlled cyclic fatigue failure tests were performed. Forces, horizontal and vertical displacements were measured; rotational permanent plastic deformations, maximal displacement ranges in the hysteresis loops of the cyclic loading responses and dynamic stiffness were determined. Results: Static compression load to failure tests revealed that all plates showed sufficient stability up to 2400 N without any signs of opposite cortex fracture, which occurred above this load in all constructs at different load levels. During the fatigue failure tests, screw breakage in the iBalance group and opposite cortex fractures in all constructs occurred only under physiological loading conditions (<2400 N). The highest fatigue strength in terms of maximal load and number of cycles performed prior to failure was observed for the ContourLock group followed by the iBalance implants, the TomoFix standard (std) and small stature (sm) plates. The PEEKPower group showed the lowest fatigue strength. Conclusions: All plates showed sufficient stability under static loading. Compared to the TomoFix and the PEEKPower plates, the ContourLock plate and iBalance implant showed a higher mechanical fatigue strength during cyclic fatigue testing. These data suggest that both mechanical static and fatigue strength increase with a wider proximal T-shaped plate design together with diverging proximal screws as used in the ContourLock plate or a closed-wedge construction as in the iBalance design. Mechanical strength of the bone-implant constructs decreases with a narrow T-shaped proximal end design and converging proximal screws (TomoFix) or a short vertical plate design (PEEKPower Plate). Whenever high mechanical strength is required, a ContourLock or iBalance plate should be selected. © 2015, Diffo Kaze et al.
引用
收藏
页码:1 / 17
页数:16
相关论文
共 30 条
[21]  
Spahn G., Kirschbaum S., Kahl E., Factors that influence high tibial osteotomy results in patients with medial gonarthritis: a score to predict the results, OsteoArthritis and Cartilage, 14, pp. 190-195, (2006)
[22]  
Staubli A.E., Radiological examination of bone healing after open-wedge tibial osteotomy, Osteotomies around the knee, pp. 131-146, (2008)
[23]  
Staubli A.E., Jacob H., Evolution of open-wedge high tibial osteotomy: experience with a special angular stable device for internal fixation without interposition material, Int Orthop, 34, pp. 167-172, (2010)
[24]  
Staubli A.E., De Simoni C., Babst R., Lobenhoffer P., TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia - early results in 92 cases, Injury, 34, pp. 55-62, (2003)
[25]  
Stoffel K., Stachowiak G., Markus K., Open wedge high tibial osteotomy: biomechanical investigation of the modified Arthrex Osteotomy Plate (Puddu Plate) and the TomoFix Plate, Clin Biomech, 19, pp. 944-950, (2004)
[26]  
Taylor W.R., Heller M.O., Bergmann G., Duda G.N., Tibio-femoral loading during human gait and stair climbing, J Orthop Res, 22, pp. 625-632, (2004)
[27]  
Valkering K.P., Van den Bekerom M.P.J., Kappelhoff F.M., Albers G.H.R., Complications after tomofix medial opening wedge high tibial osteotomy, J Knee Surg, 22, 3, pp. 218-225, (2009)
[28]  
Watanabe K., Kamiya T., Suzuki D., Otsubo H., Teramoto A., Suzuki T., Yamashita T., Biomechanical stability of open-wedge high tibial osteotomy: comparison of two locking plates, Open J Orthoped, 4, pp. 257-262, (2014)
[29]  
Woon-Hwa J., Chung-Woo C., Ji-Hoon L., Ha J.-H., Ji-Hyae K., Jae-Heon J., Comparative Study of Medial Opening-Wedge High Tibial Osteotomy Using 2 Different Implants, Arthroscopy: J Arthroscopic Related Surgery, 29, 6, pp. 1063-1071, (2013)
[30]  
Zhim F., Laflamme G.Y., Viens H., Saidane K., Yahia L., Biomechanical stability of high tibial opening wedge osteotomy: Internal fixation versus external fixation, Clinical Biomechanics, 20, pp. 871-876, (2005)