Hospital de Torrejón, C/Mateo Inurria s/n, 28850, Madrid, Spain.
Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2641-7. doi: 10.1007/s00167-013-2517-9. Epub 2013 Apr 30.
To ascertain whether changing position and size of the spacer may modify the load and displacement of the tibial plateau when performing an opening wedge high tibial osteotomy.
Fifteen sawbones tibia models were used. In the axial plane, the anterior, medial, and posterior thirds of the tibial plateau were marked, and the medial and posterior thirds were called "point 1" and "point 2", respectively. A 7.5-mm-stainless steel indenter was used to apply the load over these two points: the load applied to point 1 simulated the load to that site when the knee was extended, and the load to point 2 simulated the load to the same area when the knee was flexed. Maximum load (N) and displacement (mm) were calculated.
The system was shown to withstand higher loads with less displacement when the plate was posterior than it could do with the plate in the middle position. Significant differences were also found when comparing the anterior and middle position of the plate with the greatest displacement when the plate was anterior. The differences were increased when comparing the anterior and posterior positions of the plate. No statistical differences (n.s.) were found when using different spacers. The maximum stiffness was achieved if the plate was posterior and in point 1 indenter position, in which the force vector stands on the points of the lateral and medial supports (Fμ = 198.8 ± 61.5 N). The lowest stiffness was observed when the plate was anterior, and the force was applied to point 2 (Fμ = 29.7 ± 5.1 N).
Application of the plate in a more posterior position provides greater stability.
确定在进行开放式楔形胫骨高位截骨术时，改变间隔物的位置和大小是否会改变胫骨平台的负荷和位移。
使用了 15 个骨骼胫骨模型。在矢状面，胫骨平台的前、中、后三分之一被标记，中三分之一和后三分之一分别称为“点 1”和“点 2”。使用 7.5 毫米不锈钢压头在这两点上施加负荷：施加到点 1 的负荷模拟膝关节伸展时该部位的负荷，施加到点 2 的负荷模拟膝关节弯曲时相同区域的负荷。计算最大负荷（N）和位移（mm）。
与中间位置的钢板相比，钢板位于后方时，系统能够承受更高的负荷，同时位移更小。与钢板位于前位时相比，当钢板位于前位和中位时，也发现了显著的差异，最大位移发生在钢板位于前位时。当比较钢板的前位和后位时，差异增加。使用不同的间隔物时未发现统计学差异（n.s.）。如果钢板位于后方且压头位于点 1 位置，则可获得最大的刚度（Fμ=198.8±61.5 N），此时力矢量位于外侧和内侧支撑点上。当钢板位于前位且力施加到点 2 时，观察到最低的刚度（Fμ=29.7±5.1 N）。
将钢板置于更靠后的位置可提供更大的稳定性。
