Department of Orthopaedics and Traumatology, Meram School of Medicine, Necmettin Erbakan University, Akyokuş, Meram, Konya, Turkey.
Department of Mechanical Engineering, TOBB University of Economics and Technology, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2017 Sep;25(9):2914-2920. doi: 10.1007/s00167-016-4049-6. Epub 2016 Feb 20.
The purpose of this study was to investigate the mechanical strength of both monoplanar and biplanar medial opening-wedge high tibial osteotomy (MOWHTO) procedures and assess the risk of lateral cortex disruption for both techniques.
Twelve synthetic tibia models with cortical shells were used as test models. Saw cuts for monoplanar MOWHTO and biplanar MOWHTO were generated on the test models in equal numbers (n = 6 for both groups). Wedge opening load and wedge gap distance were evaluated via compressive tests.
The mean gap distance just before the lateral cortex fracture in the monoplanar group was 14.7 ± 2.9 mm, which was significantly narrower than that in the biplanar group of 19.1 ± 2.0 mm (p = 0.015). The mean load just before the occurrence of lateral cortex fracture of 32.4 ± 3.2 N in the monoplanar osteotomy group was significantly lower than that in the biplanar osteotomy group of 111.8 ± 9.3 N (p = 0.009).
Performing a MOWHTO via the biplanar rather than the monoplanar technique allows larger-sized wedges to be opened with less risk of lateral cortical fracture. Thus, larger gaps can be opened and higher angle corrections can be achieved using the biplanar osteotomy procedure. From a clinical viewpoint, the biplanar osteotomy technique reduced the risk of lateral cortical hinge fracture during MOWHTO.
本研究旨在探讨单平面和双平面内侧开口楔形胫骨高位截骨术（MOWHTO）的力学强度，并评估两种技术中发生外侧皮质破裂的风险。
使用 12 个具有皮质壳的合成胫骨模型作为测试模型。在测试模型上以相等数量（两组各 6 个）生成用于单平面 MOWHTO 和双平面 MOWHTO 的锯切。通过压缩试验评估楔形开口载荷和楔形间隙距离。
单平面组中发生外侧皮质骨折前的平均间隙距离为 14.7 ± 2.9mm，明显小于双平面组的 19.1 ± 2.0mm（p = 0.015）。单平面截骨组中发生外侧皮质骨折前的平均载荷为 32.4 ± 3.2N，明显低于双平面截骨组的 111.8 ± 9.3N（p = 0.009）。
与单平面技术相比，采用双平面技术进行 MOWHTO 可允许以较小的外侧皮质骨折风险来打开更大尺寸的楔形。因此，双平面截骨术可打开更大的间隙并实现更高的角度矫正。从临床角度来看，双平面截骨技术降低了 MOWHTO 过程中外侧皮质铰链骨折的风险。
