We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A synthetic bone insert may protect the lateral cortex and fixation plate following a high tibial osteotomy by reducing the tensile strains.
- Authors
MacDonald, Rachel; Huebner, Kyla; Farr, Jack; Dunning, Cynthia E.; Getgood, Alan; Burkhart, Timothy A.
- Abstract
<bold>Purpose: </bold>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.<bold>Materials and Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
OSTEOTOMY; TOTAL knee replacement; BONE fractures; TENSILE strength; ORTHOPEDICS
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2020, Vol 28, Issue 6, p1814
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05606-z