Thinner tuberosity osteotomy is more resistant to axial load in medial open-wedge distal tuberosity proximal tibial osteotomy: A biomechanical study |
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| Institution: | 1. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan;2. Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan;1. Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States;2. University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States;3. Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, United States;1. Division of Pediatric Orthopedic Surgery, Children’s Hospital Zagreb, Zagreb, Croatia;2. Department of Orthopedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia;3. Department of Technology, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia;4. Department of Forensic Medicine and Criminology, School of Medicine, University of Zagreb, Croatia;5. Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia;1. Department of Orthopedic Surgery, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA;2. Department of Clinical Operations, Mount Sinai Health System, USA |
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| Abstract: | BackgroundThe purpose of this study was to investigate axial load resistance of the tibia depending on the thickness of tibial tuberosity osteotomy in medial open-wedge distal tuberosity proximal tibial osteotomy (OWDTO). The hypothesis is that a thin tibial tuberosity osteotomy shows high axial load resistance of the tibia.MethodsThe OWDTO model was constructed from imitation bones of the tibia. Distal tibial tuberosity osteotomy was performed with thicknesses of 7, 14, and 21 mm (n = 5 for each group). Cyclic axial-load fatigue tests were performed to investigate the strain at five measurement points on the OWDTO model. An axial-load failure test was also performed to investigate the maximum strain for failure.ResultsThe 7-mm OWDTO model showed a significantly lower stain range than the 14-mm model at the middle part of the lateral hinge (P = 0.0263, mean difference: ?852.6 με), posterior part (P = 0.0465, mean difference: ?1040.0 με), posterior tibial cortex (P < 0.0001, mean difference: ?583.4 με), and plate (P = 0.0029, mean difference: ?121.6 με). There were no significant differences in the strain at the tibial tuberosity between the groups. The axial load for complete failure was significantly higher in the 7-mm model than in the 21-mm model (P = 0.0010, mean difference: 2577.0 N). The failure points were at the lateral hinges.ConclusionsThinner distal tibial tuberosity osteotomy is more resistant to axial load and may be recommended for the prevention of tibial and lateral hinge fractures after OWDTO. |
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| Keywords: | Distal tuberosity osteotomy Proximal tibial osteotomy Tibial fracture Biomechanical study Axial load Lateral hinge fracture |
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