The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates

Objectives Opening wedge high tibial osteotomy (HTO) is an established surgical procedure for the treatment of early-stage knee arthritis. Other than infection, the majority of complications are related to mechanical factors – in particular, stimulation of healing at the osteotomy site. This study u...

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Authors: MacLeod, Alisdair, Serrancolí, Gil|||0000-0001-5034-2445, Fregly, Benjamin Jon, Toms, Andrew, Gill, Harinderjit
Format: article
Publication Date:2018
Country:España
Institution:Universitat Politècnica de Catalunya (UPC)
Repository:UPCommons. Portal del coneixement obert de la UPC
Language:English
OAI Identifier:oai:upcommons.upc.edu:2117/131168
Online Access:https://hdl.handle.net/2117/131168
https://dx.doi.org/10.1302/2046-3758.712.BJR-2018-0035.R1
Access Level:Open access
Keyword:Biomechanics
Osteotomy
Plate
Stress
Biomecànica
Àrees temàtiques de la UPC::Enginyeria biomèdica::Biomecànica
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oai_identifier_str oai:upcommons.upc.edu:2117/131168
network_acronym_str ES
network_name_str España
repository_id_str
spelling The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy platesMacLeod, AlisdairSerrancolí, Gil|||0000-0001-5034-2445Fregly, Benjamin JonToms, AndrewGill, HarinderjitBiomechanicsOsteotomyPlateStressBiomecànicaÀrees temàtiques de la UPC::Enginyeria biomèdica::BiomecànicaObjectives Opening wedge high tibial osteotomy (HTO) is an established surgical procedure for the treatment of early-stage knee arthritis. Other than infection, the majority of complications are related to mechanical factors – in particular, stimulation of healing at the osteotomy site. This study used finite element (FE) analysis to investigate the effect of plate design and bridging span on interfragmentary movement (IFM) and the influence of fracture healing on plate stress and potential failure. Materials and Methods A 10° opening wedge HTO was created in a composite tibia. Imaging and strain gauge data were used to create and validate FE models. Models of an intact tibia and a tibia implanted with a custom HTO plate using two different bridging spans were validated against experimental data. Physiological muscle forces and different stages of osteotomy gap healing simulating up to six weeks postoperatively were then incorporated. Predictions of plate stress and IFM for the custom plate were compared against predictions for an industry standard plate (TomoFix). Results For both plate types, long spans increased IFM but did not substantially alter peak plate stress. The custom plate increased axial and shear IFM values by up to 24% and 47%, respectively, compared with the TomoFix. In all cases, a callus stiffness of 528 MPa was required to reduce plate stress below the fatigue strength of titanium alloy. Conclusion We demonstrate that larger bridging spans in opening wedge HTO increase IFM without substantially increasing plate stress. The results indicate, however, that callus healing is required to prevent fatigue failure.Peer Reviewed20182018-12-0320192019-04-03journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/2117/131168https://dx.doi.org/10.1302/2046-3758.712.BJR-2018-0035.R1reponame:UPCommons. Portal del coneixement obert de la UPCinstname:Universitat Politècnica de Catalunya (UPC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivs 3.0 Spainhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:upcommons.upc.edu:2117/1311682026-05-27T15:37:01Z
dc.title.none.fl_str_mv The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
title The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
spellingShingle The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
MacLeod, Alisdair
Biomechanics
Osteotomy
Plate
Stress
Biomecànica
Àrees temàtiques de la UPC::Enginyeria biomèdica::Biomecànica
title_short The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
title_full The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
title_fullStr The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
title_full_unstemmed The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
title_sort The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates
dc.creator.none.fl_str_mv MacLeod, Alisdair
Serrancolí, Gil|||0000-0001-5034-2445
Fregly, Benjamin Jon
Toms, Andrew
Gill, Harinderjit
author MacLeod, Alisdair
author_facet MacLeod, Alisdair
Serrancolí, Gil|||0000-0001-5034-2445
Fregly, Benjamin Jon
Toms, Andrew
Gill, Harinderjit
author_role author
author2 Serrancolí, Gil|||0000-0001-5034-2445
Fregly, Benjamin Jon
Toms, Andrew
Gill, Harinderjit
author2_role author
author
author
author
dc.subject.none.fl_str_mv Biomechanics
Osteotomy
Plate
Stress
Biomecànica
Àrees temàtiques de la UPC::Enginyeria biomèdica::Biomecànica
topic Biomechanics
Osteotomy
Plate
Stress
Biomecànica
Àrees temàtiques de la UPC::Enginyeria biomèdica::Biomecànica
description Objectives Opening wedge high tibial osteotomy (HTO) is an established surgical procedure for the treatment of early-stage knee arthritis. Other than infection, the majority of complications are related to mechanical factors – in particular, stimulation of healing at the osteotomy site. This study used finite element (FE) analysis to investigate the effect of plate design and bridging span on interfragmentary movement (IFM) and the influence of fracture healing on plate stress and potential failure. Materials and Methods A 10° opening wedge HTO was created in a composite tibia. Imaging and strain gauge data were used to create and validate FE models. Models of an intact tibia and a tibia implanted with a custom HTO plate using two different bridging spans were validated against experimental data. Physiological muscle forces and different stages of osteotomy gap healing simulating up to six weeks postoperatively were then incorporated. Predictions of plate stress and IFM for the custom plate were compared against predictions for an industry standard plate (TomoFix). Results For both plate types, long spans increased IFM but did not substantially alter peak plate stress. The custom plate increased axial and shear IFM values by up to 24% and 47%, respectively, compared with the TomoFix. In all cases, a callus stiffness of 528 MPa was required to reduce plate stress below the fatigue strength of titanium alloy. Conclusion We demonstrate that larger bridging spans in opening wedge HTO increase IFM without substantially increasing plate stress. The results indicate, however, that callus healing is required to prevent fatigue failure.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-12-03
2019
2019-04-03
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/2117/131168
https://dx.doi.org/10.1302/2046-3758.712.BJR-2018-0035.R1
url https://hdl.handle.net/2117/131168
https://dx.doi.org/10.1302/2046-3758.712.BJR-2018-0035.R1
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivs 3.0 Spain
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivs 3.0 Spain
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:UPCommons. Portal del coneixement obert de la UPC
instname:Universitat Politècnica de Catalunya (UPC)
instname_str Universitat Politècnica de Catalunya (UPC)
reponame_str UPCommons. Portal del coneixement obert de la UPC
collection UPCommons. Portal del coneixement obert de la UPC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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