Abstract
Background
Combined proximal tibial osteotomy (CPTO) is an innovative and effective procedure
for correcting varus knee osteoarthritis (VKOA) with intra- and extra-articular deformity.
Here, we designed a novel internal fixation plate system for CPTO and assessed the
biomechanical strength of the bone-implant.
Methods
Our newly designed CPTO internal fixation plate system included a specialized plate
shape, combination holes, locking screw holes, screw position, and size of fixation.
The biomechanical performance of this plate system in CPTO treatment was compared
via finite element analysis (FEA) to traditional Tomofix devices implanted in the
opening-wedge high tibial osteotomy (OWHTO), tibial condylar valgus osteotomy (TCVO),
and CPTO.
Results
The tibial wedge stiffness and displacement after CPTO implantation of the novel internal
plate fixation increased by 9.6%, which was -65% higher than the CPTO with the Tomofix
system. The average stress of the bone, plate, and screws in the CPTO implanted the
novel designed plate system compared to the Tomofix system decreased by 12.7%, 1.9%,
and 20.3 %, respectively. The device maximum stress and wedge stiffness after CPTO
with the novel plate system versus traditional OWHTO and TCVO with the Tomofix system
were 255.7 MPa, 204 MPa, 130.4 MPa, and 678.9 N/mm, 660.3 N/mm, 1626.0 N/mm, respectively.
Conclusions
The novel internal fixation plate system usage during CPTO exhibited similar bone-implant
biomechanical strength, compared to OWHTO, but with enhanced construct stability.
Keywords
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Article info
Publication history
Published online: May 19, 2022
Accepted:
May 17,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
