A pilot study to assess the safety and radiological performance of a new low-profile locking plate for high tibial osteotomy

Pagkalos, Joseph; Hussain, Faisal Nazeer; Karargyris, Orestis; Snow, Martyn

doi:10.1016/j.knee.2018.05.013

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…HTO necessitates osteosynthesis (fixation of bone), using metallic plates to internally fixate and stabilise the joint, allowing the patient to engage in daily activities [16]. Despite evidence of good long-term outcomes [17], the 'one-size-fits-all' approach in HTO has limited its surgical adoption [18,19], primarily due to size and rigidity of the plates [20,21]. Patient-specific AM devices have begun to address the limitations of 'one-size-fits-all' approach in HTO [22].…”

Section: Introductionmentioning

confidence: 99%

Detailed design for additive manufacturing and post processing of generatively designed high tibial osteotomy fixation plates

et al. 2022

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Integration of advanced technologies have revitalised treatment methods in the current clinical practice. In orthopaedic surgery, patient-specific implants have leveraged the design freedom offered by additive manufacturing (AM) exploiting the capabilities within powder bed fusion processes. Furthermore, generative design (GD), a design exploration tool based on the artificial intelligence, can integrate manufacturing constraints in the concept development phase, consequently bridging the gap between AM design and manufacturing. However, the reproducibility of implant prototypes are severely constrained due to uncomprehensive information on manufacturing and post processing techniques in the detailed design phase. This paper explores the manufacturing feasibility of novel GD concept plate designs for High Tibial Osteotomy (HTO), a joint preserving surgery for a patient diagnosed with osteoarthritis in the knee. A design for AM (DfAM) workflow for a generatively designed HTO plate is presented, including; detailed DfAM of GD concept designs, fabrication of plate prototypes using electron beam powder bed fusion (PBF-EB) of medical grade Ti-6Al-4 V, post processing and inspection. The study established PBF-EB as a suitable manufacturing method for the highly complex GD plate fixations, through evaluating the impact of manufacturing and post processing on the surface finish and geometrical precision of the plate design features.

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Section: Introductionmentioning

confidence: 99%

Detailed design for additive manufacturing and post processing of generatively designed high tibial osteotomy fixation plates

et al. 2022

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“… ∥ References 1-3, 4-9, 12-14, 16-21, 23-36, 39-44, 46, 50-54, 56, 57, 59-63, 65-67, 69-79, 81, 83-85, 92, 93. …”

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confidence: 99%

Incidence of Complications and Revision Surgery After High Tibial Osteotomy: A Systematic Review

et al. 2023

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Background: High tibial osteotomy (HTO) is a well-recognized procedure for its effectiveness in treating symptomatic early knee arthritis and malalignment. Although there are numerous systematic reviews evaluating the management and outcomes after HTO, there are few investigations on complications of this procedure. Purpose: To systematically review the literature to determine the incidence of intraoperative and postoperative complications associated with medial opening wedge and lateral closing wedge HTOs. Study Design: Systematic review; Level of evidence, 4. Methods: The Cochrane Database of Systematic Reviews, PubMed, Embase, and MEDLINE databases were queried for studies reporting complications associated with HTO with or without concomitant procedures. Data including patient characteristics, procedure type, concomitant procedures, follow-up time, and postoperative imaging were extracted. Rates of intra- and postoperative complications, reoperations, and conversion to arthroplasty were recorded. Results: A total of 71 studies were included for analysis, comprising 7836 patients. The overall intraoperative complication rate during HTO was 5.5% (range, 0%-29.3%), and the overall postoperative complication rate was 6.9% (range, 0%-26.6%). The most common intraoperative complication was lateral hinge fracture (incidence, 9.1%; range, 0%-30.4%) in medially based HTOs and peroneal nerve injury in laterally based HTOs (incidence, 3.2%; range, 0%-8.7%). The overall incidence of neurovascular injury after medially or laterally based HTOs was 1.1% (range, 0%-18.9%). The most common postoperative complication was superficial infection (incidence, 2.2%; range, 0%-13%). Of the included studies, 62 included postoperative radiographic analysis, and among those, the incidence of nonunion was 1.9% (range, 0%-15.5%), loss of correction was 1.2% (range, 0%-34.3%), and implant failure was 1.0% (range, 0%-10.2%). Among studies reporting revision surgeries, the overall reoperation rate was 15.5% (range, 0%-70.7%), with the most common type of reoperation being hardware removal (incidence, 10.0%; range, 0%-60%). Conclusion: Intraoperatively, medially based HTOs are associated with a 1 in 20 risk of lateral hinge fracture and laterally based HTOs with a 1 in 30 risk of peroneal nerve injury. Postoperative complication rates in the range of 10% to 15% can be expected, including infection (2.9%), loss of correction (1.2%), and nonunion (1.9%). Patients should also be counseled that the reoperation rate is approximately 15%, with hardware removal being the most common procedure.

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Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant-Related Pain Relief and Functional Improvement

Lee,

Shin,

Hong

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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A pilot study to assess the safety and radiological performance of a new low-profile locking plate for high tibial osteotomy

Cited by 4 publications

References 29 publications

Detailed design for additive manufacturing and post processing of generatively designed high tibial osteotomy fixation plates

Detailed design for additive manufacturing and post processing of generatively designed high tibial osteotomy fixation plates

Incidence of Complications and Revision Surgery After High Tibial Osteotomy: A Systematic Review

Implant Removal After Medial Opening Wedge High Tibial Osteotomy Provides Implant-Related Pain Relief and Functional Improvement

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