Paper 145: Biomechanical Stability of Open Wedge High Tibial Osteotomy: Comparison of Two Locking Plates
Bibliographic record
Abstract
Recently, plates with locking screws have been developed and used for open wedge high tibial osteotomy (HTO) in knee osteoarthritis patients. These plates are believed to achieve more ridged fixation compared with the conventional plates, however, basic studies about biomechanical stability or comparison of the plates are not enough. The purpose of this study was to evaluate and compare biomechanical stability of the currently available two plates using fresh-frozen cadaveric specimens. Three paired lower extremities (6 legs) were studied. Soft tissues were removed except the ligaments and the specimens were vertically embedded in steel boxes. A specially designed metal device was fixed on the proximal surface of the tibia and the vertical load could be applied at the tibial lateral plateau through the device. The specimens were placed in a mechanical testing machine (AG-X, Shimazu, Japan) which could measure the applied loads and displacement simultaneously while applying the vertical load precisely. Two locking plates were used for HTO; Arthrex opening wedge plate system (Puddu locking plate) (Arthrex Inc., USA) was a short titanium plate with a spacer to open the osteotomy space, and Tomofix plate (Mathys Inc., Switzerland) was a long and T-shaped titanium plate. A standardized medial open wedge osteotomy technique was used with the lateral tibial cortex spared. The axial compression load was applied to each intact bone from 0N to 550N at a rate of 1 mm/min. Then HTO was performed and the same test was repeated. Finally, the compression load was applied until failure. One leg of a specimen was fixed with the Puddu locking plate and the other side of the leg was fixed with the Tomofix plate to compare the data of the two plates in the same specimen. The load-displacement data were analyzed for each condition to calculate stiffness and the failure load, and a description of the fracture was recorded. The mean value of stiffness was 1432.5 N/mm in the intact bones. Stiffness decreased after HTO with the Puddu locking plate (583.9N/mm) or the Tomofix plate (792.6N/mm). In the failure test, failures resulted in bone fracture at the lateral spared cortex of the osteotomy level. This study will provide important information for the consideration of implant selection, modification of the procedure, and the rehabilitation program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".