The Stability of Three Commercially Available Implants Used in Medial Opening Wedge High Tibial Osteotomy

Abstract

This biomechanical study tested three commercially available fi xation devices for medial opening wedge high tibial osteotomy (HTO). A medial opening wedge HTO model was created on replicate tibias.Fixation was achieved with one of three fi xation devices: VS Osteotomy plate (EBI, Parsippany, NJ), Arthrex Osteotomy plate (Arthrex, Naples, Fla), and OsteoTrac plate (DJ Orthopedics Inc, Vista, Calif). For each fi xation system, seven specimens were cyclically loaded in compression and torsion under physiologic loads on a servohydraulic machine.Mean axial stiffness was 2425 N/mm, 2358 N/mm and 2258 N/mm, respectively, for the EBI, Arthrex, and Alaron surgical plates. Mean torsional stiffness was 4.5 Nm/degree, 4.1 Nm/degree and 4.0 Nm/degree, respectively, for the EBI, Arthrex, and DJ Orthopedics surgical plates. Though the differences are not statistically signifi cant between the three fi xation devices (Pϭ.74 for mean axial stiffness and Pϭ.10 for mean torsional stiffness), there is insuffi cient statistical power to rule out a true difference.Using this replicate tibia model, all three fi xation devices tested appear to successfully stabilize the osteotomy site with regards to physiologic axial and torsional loads. [J Knee Surg. 2006;19:95-98.]

Stability of medial opening wedge high tibial osteotomy: a failure analysis

“…In our series the Puddu I plate is inadequate for fixation of opening wedge osteotomies, which is in contrast to other authors who have reported good results [6]. Our study led us to abandon the Puddu I plate for medial opening wedge osteotomy.…”

“…A number of studies have reported on stability of various implants [6,20,23]. These studies have also shown that it is not the axial but the torsional loading which presents problems.…”

Comparison of theoretical fixation stability of three devices employed in medial opening wedge high tibial osteotomy: a finite element analysis

“…Although biomechanical tests confirmed the adequacy of the fixation and load stability of the Puddu like plates with an insert and without locking head screws [9-11], some authors raised concerns with the first generation Puddu plate in clinical case series [22,26,27]. On the other hand, the biomechanical study by Stoffel et al concluded that the TomoFix plate provides superior stability in both compression and torsion compared to the Puddu Plate and that in the latter case additional fixation might be required [12].…”

Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis

“…Computer modelling (Specogna et al 2007; Bhatnagar and Jenkyn 2010), cadaveric and gait (Johnson et al 1980; Andriacchi et al 2000; Hurwitz et al 2002) studies have contributed some basic understanding (Andriacchi et al 2000; Chao 2003; Zhim et al 2005; Agneskirchner et al 2006) of the procedure but no method currently exists to plan malalignment correction to minimise excessive knee joint pressure (Dorsey et al 2006; Esenkaya et al 2007; Bhatnagar and Jenkyn 2010). The 2D model implemented in the OASIS software by Chao et al, although capable of estimating contact forces, cannot predict contact stress (Chao and Sim 1995; Chao 2003).…”