Ettinger Sarah, Schwarze Michael, Yao Daiwei, Ettinger Max, Claassen Leif, Stukenborg-Colsman Christina, Thermann Hajo, Plaass Christian
Department of Foot and Ankle Surgery, Orthopaedic Clinic at DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
Biomechanical Laboratory, Orthopaedic Clinic, Hannover Medical School, Hannover, Germany.
Arch Orthop Trauma Surg. 2018 Oct;138(10):1359-1363. doi: 10.1007/s00402-018-2981-2. Epub 2018 Jun 22.
With ankle arthritis often affecting young patients, joint-sparing treatments instead of total joint replacement should be considered. Only a few implants were specially developed for supramalleolar osteotomies (SMOT). This study was performed to analyse the stability of different implants and their appropriateness for SMOT.
Twenty-five bone models (Sawbone Europe, Malmö, Sweden) were used for biomechanical testing. SMOT were performed as a uniplanar osteotomy, leaving 5 mm of lateral bone intact with a standardized gap of 8 mm. Five different plates commonly used for SMOT were assessed. For axial stability, the constructs were tested during 100 cycles for each load (150N and 800N) at a rate of 0.5 Hz. For rotational stability, each construct was subject to 100 cycles of 5 Nm torque at a rate of 0.25 Hz, performing three runs with an axial preload of 0N, 150N, or 800N. Ultimate axial load was performed for one-half and ultimate rotational load was performed for the other half of the constructs. In addition, the stiffness of the different constructs after failure was tested.
All constructs showed high stability and could be tested until maximum cyclic load. There was no significant difference between the five plates, neither for stiffness (axial or rotational) nor for failure load (axial or rotational). One plate indicated superiority in axial failure testing without any significant difference.
All implants could be tested until maximum load. The intact hinge apparently provides enough support to compensate for lower moment of inertia of some plates.
Not applicable.
踝关节关节炎常影响年轻患者，应考虑采用保留关节的治疗方法而非全关节置换。专门为踝关节上截骨术（SMOT）开发的植入物很少。本研究旨在分析不同植入物的稳定性及其对SMOT的适用性。
使用25个骨模型（欧洲Sawbone公司，瑞典马尔默）进行生物力学测试。SMOT采用单平面截骨术，外侧保留5mm完整骨，标准化间隙为8mm。评估了五种常用于SMOT的不同钢板。对于轴向稳定性，在0.5Hz的频率下，对每个载荷（150N和800N）的构建体进行100个循环的测试。对于旋转稳定性，每个构建体在0.25Hz的频率下承受100个循环的5Nm扭矩，分别在轴向预载荷为0N、150N或800N的情况下进行三次测试。对一半构建体进行极限轴向载荷测试，对另一半构建体进行极限旋转载荷测试。此外，测试了不同构建体失效后的刚度。
所有构建体均显示出高稳定性，并且可以测试至最大循环载荷。五种钢板在刚度（轴向或旋转）和失效载荷（轴向或旋转）方面均无显著差异。一种钢板在轴向失效测试中显示出优势，但无显著差异。
所有植入物均可测试至最大载荷。完整的铰链显然提供了足够的支撑，以补偿某些钢板较低的惯性矩。
不适用。
