Placement-induced effects on high tibial osteotomized construct - biomechanical tests and finite-element analyses Orthopedics and biomechanics

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題名:	Placement-induced effects on high tibial osteotomized construct - biomechanical tests and finite-element analyses Orthopedics and biomechanics
作者:	曾清秀;Luo, Chu-An;Hwa, Su-Yang;Lin, Shang-Chih;Chen, Chun-Ming;Tseng, Ching-Shiow
貢獻者:	工學院機械工程學系
關鍵詞:	Analysis;Biomechanical Phenomena - physiology;Biomechanics;Bone Plates;Bone Screws;Bones;Computer software industry;Epidemiology;Finite Element Analysis;Finite element method;Fractures;Health aspects;Humans;Internal fixation in fractures;Internal Medicine;Medicine;Medicine & Public Health;Models, Anatomic;Musculoskeletal diseases;Orthopedics;Osteotomy - instrumentation;Osteotomy - methods;Rehabilitation;Research Article;Rheumatology;Software;Sports Medicine;Tibia - anatomy & histology;Tibia - physiology;Tibia - surgery
日期:	2015-12-01
上傳時間:	2026-04-23 15:22:22 (UTC+8)
出版者:	London: BioMed Central
摘要:	摘要： Background High tibial osteotomy (HTO) with a medially opening wedge has been used to treat osteoarthritic knees. However, the osteotomized tibia becomes a highly unstable structure and necessitates the use of plate and screws to stabilize the medial opening and enhance bone healing. A T-shaped plate (e.g. TomoFix) with locking screws has been extensively used as a stabilizer of the HTO wedge. From the biomechanical viewpoint, however, the different plate sites and support bases of the HTO plate should affect the load-transferring path and wedge-stabilizing ability of the HTO construct. This study uses biomechanical tests and finite-element analyses to evaluate the placement- and base-induced effects of the HTO plates on construct performance. Methods Test-grade synthetic tibiae are chosen as the standard specimens of the static tests. A medial wedge is created for each specimen and stabilized by three plate variations: hybrid use of T- and I-shaped plates (TIP), anteriorly placed TomoFix (APT), and medially placed TomoFix (MPT). There are five tests for each variation. The failure loads of the three constructs are measured and used as the load references of the fatigue finite-element analysis. The residual life after two hundred thousand cycles is predicted for all variations. Results The testing results show no occurrence of implant back-out and breakage under all variations. However, the wedge fracture consistently occurs at the opening tip for the APT and MPT and the medially resected plateau for the TIP, respectively. The testing results reveal that both failure load and wedge stiffness of the TIP are the highest, followed by the MPT, while those of the APT are the least ( P < 0.05). The fatigue analyses predict comparable values of residual life for the TIP and MPT and the highest value of damage accumulation for the APT. Both experimental and numerical tests show the biomechanical disadvantage of the APT than their counterparts. However, the TIP construct without locking screws shows the highest stress at the plate-screw interfaces. Conclusions This study demonstrates the significant effect of placement site and support base on the construct behaviors. The TIP provides a wider base for supporting the HTO wedge even without the use of locking screws, thus significantly enhancing construct stiffness and suppressing wedge fracture. Compared to the APT, the MPT shows performance more comparable to that of the TIP. If a single plate and a smaller incision are considered, the MPT is recommended as the better alternative for stabilizing the medial HTO wedge. 其他題名： BMC Musculoskelet Disord 出版者： London: BioMed Central 出版日期： 2015-09-04 出處： BMC musculoskeletal disorders, 2015-09, Vol.16 (1), p.235-235, Article 235 資源來源： Publicly Available Content Database (Proquest) 版權： Luo et al. 2015 版權： COPYRIGHT 2015 BioMed Central Ltd. 版權： Copyright BioMed Central 2015 識別號： ISSN: 1471-2474 識別號： EISSN: 1471-2474 識別號： DOI: 10.1186/s12891-015-0630-2 識別號： PMID: 26337985
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