Stress and stability comparison between different systems for high tibial osteotomies

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题名:	Stress and stability comparison between different systems for high tibial osteotomies
作者:	曾清秀;Luo, Chu-An;Hua, Shi-Yuan;Lin, Shang-Chih;Chen, Chun-Ming;Tseng, Ching-Shiow
贡献者:	工學院機械工程學系
关键词:	Analysis;Biomechanics;Bone Plates - standards;Bone Screws - standards;Bone surgery;Care and treatment;Computer software industry;Epidemiology;Finite element analysis;Health aspects;Humans;Internal Medicine;Male;Medicine;Medicine & Public Health;Middle Aged;Musculoskeletal diseases;Obesity;Orthopedics;Orthopedics and biomechanics;Osteoarthritis;Osteotomy;Osteotomy - instrumentation;Osteotomy - methods;Osteotomy - standards;Patient outcomes;Physiological aspects;Rehabilitation;Research Article;Rheumatology;Software;Sports Medicine;Stress, Mechanical;Studies;Surgery;Tibia - diagnostic imaging;Tibia - physiology;Tibia - surgery;Tomography, X-Ray Computed;Weight-Bearing - physiology
日期:	2013-03-27
上传时间:	2026-04-23 15:28:14 (UTC+8)
出版者:	London: BioMed Central
摘要:	摘要： Background High tibial osteotomy (HTO) with a medial opening wedge has been used to treat medial compartment osteoarthritis. However, this makes the proximal tibia a highly unstable structure and causes plate and screws to be the potentials sources for mechanical failure. Consequently, proper design and use of the fixation device are essential to the HTO especially for overweight or full weight-bearing patients. Methods Based on the CT-based images, a tibial finite-element model with medial opening was simulated and instrumented with one-leg and two-leg plate systems. The construct was subjected to physiological and surgical loads. Construct stresses and wedge micromotions were chosen as the comparison indices. Results The use of locking screws can stabilize the construct and decrease the implant and bone stresses. Comparatively, the two-leg design provides a wider load-sharing base to form a force-couple mechanism that effectively reduces construct stresses and wedge micromotions. However, the incision size, muscular stripping, and structural rigidity are the major concerns of using the two-leg systems. The one-leg plates behave as the fulcrum of the leverage system and make the wedge tip the zone of tension and thus have been reported to negatively affect the callus formation. Conclusions The choice of the HTO plates involved the trade-off between surgical convenience, construct stability, and stress-shielding effect. If the stability of the medial opening is the major concern, the two-leg system is suggested for the patients with heavy load demands and greater proximal tibial size. The one-leg system with locking screws can be used for the majority of the patients without heavy bodyweight and poor bone quality. 其他題名： BMC Musculoskelet Disord 出版者： London: BioMed Central 出版日期： 2013-03-25 出處： BMC musculoskeletal disorders, 2013-03, Vol.14 (1), p.110-110, Article 110 資源來源： EBSCOhost Academic Search Premier 版權： Luo et al.; licensee BioMed Central Ltd. 2013 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 版權： COPYRIGHT 2013 BioMed Central Ltd. 版權： 2013 Luo et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 版權： Copyright © 2013 Luo et al.; licensee BioMed Central Ltd. 2013 Luo et al.; licensee BioMed Central Ltd. 識別號： ISSN: 1471-2474 識別號： EISSN: 1471-2474 識別號： DOI: 10.1186/1471-2474-14-110 識別號： PMID: 23530858
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