Biomechanical Stability of a Retrotubercle Opening-Wedge High Tibial Osteotomy
Bibliographic record
Abstract
In recent years, opening-wedge osteotomy has gained popularity. However, the complication rate reported is high. Opening-wedge osteotomy was modified to remedy the problems seen with the conventional technique including loss of correction, delayed healing, and patella infera. This biomechanical study evaluates the response of a new opening-wedge osteotomy in a static and dynamic mode of human cadavers. Results were compared to the stability of the conventional technique. Six preserved pairs of human cadaveric knees were tested. Specimens of the same pair were randomly assigned to either the modified or conventional osteotomy. Internal fixation was used to ensure precise correction and prevent bone collapse. Each tibia was loaded on a material testing system from 0 to 700 N for 10,000 cycles to simulate immediate full weight bearing in a walking individual. Specimens were then loaded to failure to determine ultimate load and stiffness of the construct. Displacement of the articular fragment and stiffness were measured during dynamic loading. Load to failure, displacement, and stiffness were measured during static testing. The modified osteotomy provided significantly greater stiffness (1392 N/mm) and smaller loss of correction (.68 mm) than the conventional osteotomy (741 N/mm; 1.76 mm) under cyclic loading conditions (P<.05). The modified retrotubercle osteotomy provides greater stiffness than the conventional osteotomy, increasing stability by 62% and minimizing loss of correction to <1 mm. The modified osteotomy eliminates the need for bone graft and provides additional strength to allow accelerated rehabilitation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".