J Korean Orthop Res Soc.  2007 Oct;10(2):76-82.

The Change of Stress Distribution according to Fixation Devices and Osteotomy Methods in High Tibial Osteotomy

• Cho SH
• An SH
• Park HB
• Jeong ST
• Hwang SC

Abstract

PURPOSE: To evaluate the necessity of lateral translation and the primary stability of the fixation devices in a closed wedge high tibial osteotomy.
MATERIALS AND METHODS
The authors studied four pairs of high tibial osteotomy: Pair I, lateral translation with blade plate fixation; Pair II, lateral translation with staple fixation; Pair III, no translation with blade plate fixation; Pair IV, no translation with staple fixation. Four models of bovine tibia were taken and analyzed for stress distribution at the osteotomy site under axial loading. After axial loading, information recorded in pressure sensitive film was transformed to image file. After, by using image analysis software, the mean stress value and maximum stress value was calculated.
RESULTS
The mean stress calculated at each osteotomy site is as follows; 3.89 MPa in the first pair; 4.55 MPa in the second pair; 4.62 MPa in the third pair; and 4.67 MPa in the fourth pair. In Group I, stress value was distributed evenly. But in group II, III, IV, the stress was concentrated at posteromedial area of the osteotomy site.
CONCLUSION
The primary in the high tibial osteotomy was dependent more on the rigid fixation than on the continuity of the medial cortex. The pairs on which blade plate fixation was used more stable than the pairs on which staple fixation was used regardless of lateral translation.

Keyword

High tibial osteotomy; Blade plate; Staple; Stability

MeSH Terms

Osteotomy*
Tibia