新型设计接骨板系统治疗内翻型膝关节骨关节炎合并胫骨近端截骨术的生物力学评估：有限元分析。

Biomechanical evaluation of combined proximal tibial osteotomy for varus knee osteoarthritis implanted novel designed plate system: Finite element analysis.

机构信息

School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.

出版信息

Injury. 2022 Jul;53(7):2416-2423. doi: 10.1016/j.injury.2022.05.012. Epub 2022 May 20.

DOI:10.1016/j.injury.2022.05.012

PMID:35618538

Abstract

BACKGROUND

Combined proximal tibial osteotomy (CPTO) is an innovative and effective procedure for correcting varus knee osteoarthritis (VKOA) with intra- and extra-articular deformity. Here, we designed a novel internal fixation plate system for CPTO and assessed the biomechanical strength of the bone-implant.

METHODS

Our newly designed CPTO internal fixation plate system included a specialized plate shape, combination holes, locking screw holes, screw position, and size of fixation. The biomechanical performance of this plate system in CPTO treatment was compared via finite element analysis (FEA) to traditional Tomofix devices implanted in the opening-wedge high tibial osteotomy (OWHTO), tibial condylar valgus osteotomy (TCVO), and CPTO.

RESULTS

The tibial wedge stiffness and displacement after CPTO implantation of the novel internal plate fixation increased by 9.6%, which was -65% higher than the CPTO with the Tomofix system. The average stress of the bone, plate, and screws in the CPTO implanted the novel designed plate system compared to the Tomofix system decreased by 12.7%, 1.9%, and 20.3 %, respectively. The device maximum stress and wedge stiffness after CPTO with the novel plate system versus traditional OWHTO and TCVO with the Tomofix system were 255.7 MPa, 204 MPa, 130.4 MPa, and 678.9 N/mm, 660.3 N/mm, 1626.0 N/mm, respectively.

CONCLUSIONS

The novel internal fixation plate system usage during CPTO exhibited similar bone-implant biomechanical strength, compared to OWHTO, but with enhanced construct stability.

摘要

背景

联合胫骨近端截骨术（CPTO）是一种创新性且有效的方法，可矫正伴内、外畸形的膝内翻骨关节炎（VKOA）。在此，我们设计了一种新型 CPTO 内固定钢板系统，并评估了骨-植入物的生物力学强度。

方法

我们新设计的 CPTO 内固定钢板系统包括特殊的钢板形状、组合孔、锁定螺钉孔、螺钉位置和固定尺寸。通过有限元分析（FEA）比较了该钢板系统在 CPTO 治疗中的生物力学性能，与传统的 Tomofix 装置在开放式楔形胫骨高位截骨术（OWHTO）、胫骨髁间突外翻截骨术（TCVO）和 CPTO 中的应用。

结果

新型内固定钢板固定 CPTO 植入后的胫骨楔刚度和位移增加了 9.6%，比 Tomofix 系统高 65%。新型设计钢板系统 CPTO 植入的骨、钢板和螺钉的平均应力比 Tomofix 系统分别降低了 12.7%、1.9%和 20.3%。与传统的 OWHTO 和 TCVO 相比，新型钢板系统 CPTO 后装置最大应力和楔刚度分别为 255.7 MPa、204 MPa、130.4 MPa 和 678.9 N/mm、660.3 N/mm、1626.0 N/mm。