Clin Orthop Surg.  2016 Dec;8(4):373-378. 10.4055/cios.2016.8.4.373.

Biomechanical Analysis of a Novel Wedge Locking Plate in a Porcine Tibial Model

• Ha JK
• Yeom CH
• Jang HS
• Song HE
• Lee SJ
• Kim KH
• Chung KS
• Bhat MG
• Kim JG

• KMID: 2412318
• DOI: http://doi.org/10.4055/cios.2016.8.4.373

Abstract

BACKGROUND
The purpose of this study was to analyze biomechanical properties of a novel wedge locking plate in medial open wedge high tibial osteotomy (OWHTO) in a porcine tibial model.
METHODS
A uniform 8-mm OWHTO was performed in 12 porcine tibiae. Six of them were subsequently fixed with the plate without a wedge, whereas the other 6 were additionally reinforced with a metal wedge of 8 mm. Biomechanical properties (stiffness, displacement of the osteotomy gap, and failure load) were evaluated under axial load. The different modes of failure were also investigated.
RESULTS
The plate showed an axial stiffness of 2,457 ± 450 N/mm with a wedge and 1,969 ± 874 N/mm without a wedge. The maximum failure load was 5,380 ± 952 N with a wedge and 4,354 ± 607 N without a wedge. The plate with a wedge had a significantly greater failure load and significantly less displacement of medial gap at failure than that without a wedge (p = 0.041 and p = 0.002, respectively). The axial stiffness was not different between the two types of fixation. Most failures were caused by lateral cortex breakage and there was no implant failure.
CONCLUSIONS
The novel wedge locking plate showed excellent biomechanical properties and an additional wedge provided significant improvement. This plate can be a good fixation method for OWHTO.

Keyword

Knee; High tibial osteotomy; Open wedge osteotomy

MeSH Terms

Animals
Biomechanical Phenomena/*physiology
*Bone Plates
Female
Fracture Fixation, Internal/*instrumentation/methods
Osteotomy/methods
Swine
Tibia/*surgery

Figure

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  Fig. 1 A novel wedge locking plate.

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  Fig. 2 Testing model mounted on MTS (MTS 858 Bionix; MTS System Co.). A prosthesis for total knee replacement was used for the axial load. The specimen was embedded in polyurethane casting resin and mounted in a fixture.

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  Fig. 3 Schematic drawing of four markers for the displacement measurement (ventral and dorsal sides of both proximal and distal tibial surfaces). 1 and 2 are for posteromedial gap and 3 and 4 are for anterolateral gap.

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  Fig. 4 A graph for the medial gap displacement. At failure load, significant difference was shown between two groups.

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