Brooks P J, Walker P S, Scott R D
Clin Orthop Relat Res. 1984 Apr(184):302-8.
A stylized wedge-shaped defect was created in the medial plateau of autopsy specimens of the tibia to evaluate methods for fixation in total knee arthroplasty. A series of tibial components was inserted by five different methods. With each method loading of up to 1780 N axially and a varus load of 1340 N at 28 Newton-meters were assessed. The vertical deflections of the medial and lateral sides of the tray relative to the bone were measured while bending of the stem was recorded with strain gauges. The greatest deflections occurred when cement alone filled the defect; only slight improvement resulted from the addition of two cancellous screws to buttress the metal tray. Further improvement occurred when solid spacers of Plexiglas or metal were used. Finally, the most secure support was obtained with an integral custom-made tibial component. A central stem 70 mm long carried 23%-38% of the axial load, considered useful in the situation of deficient proximal bone. A metal wedge was considered an acceptable alternative to a custom-made component and may prove useful in the reconstruction of tibial bone stock defects.
在胫骨尸检标本的内侧平台制造一个风格化的楔形缺损，以评估全膝关节置换术中的固定方法。通过五种不同方法插入一系列胫骨组件。对每种方法轴向施加高达1780 N的载荷，并在28牛顿 - 米的情况下施加1340 N的内翻载荷进行评估。测量托盘内侧和外侧相对于骨骼的垂直挠度，同时用应变片记录柄部的弯曲情况。当仅用骨水泥填充缺损时出现最大挠度；添加两个松质骨螺钉以支撑金属托盘仅带来轻微改善。使用有机玻璃或金属实心垫片时进一步改善。最后，使用一体式定制胫骨组件获得最稳固的支撑。一根70毫米长的中央柄部承受23% - 38%的轴向载荷，这在近端骨量不足的情况下被认为是有用的。金属楔形物被认为是定制组件的可接受替代物，并且可能在胫骨骨量缺损的重建中证明有用。
