Biomechanical investigation of the type and configuration of screws used in high tibial osteotomy with titanium locking plate and screw fixation

Yen Nien Chen, Chih-Wei Chang, Chun Ting Li, Chih Hsien Chen, Chi Rung Chung, Chih-Han Chang, Yao Te Peng

研究成果: Article

摘要

Background: To maintain the corrected alignment after high tibial osteotomy (HTO), fixation with titanium locking plate and screws is widely used in current practice; however, screw breakage is a common complication. Thus, this study was to investigate the mechanical stability of HTO with locking plate and various screw fixations, including the length as well as the type. Methods: A finite element (FE) model involving a distal femur, meniscus, and a proximal tibia with HTO fixed with a titanium locking plate and screws was created. The angle of the medial open wedge was 12°, and bone graft was not used. Two types of screws, namely conventional locking and far-cortical locking screws, with various lengths and configurations were used. At the proximal tibia, conventional locking screws with different lengths, 30 and 55 mm, were used; at the tibia shaft, different screw fixations including one-cortical, two-cortical, and far-cortical locking screws were used. Results: The use of far-cortical locking screw generated the highest equivalent stress on the screws, which was four times (from 137.3 to 541 MPa) higher than that of the one-cortical screw. Also, it led to the maximum deformation of the tibia and a greater gap deformation at the osteotomy site, which was twice (from 0.222 to 0.442 mm) larger than that of the one-cortical screw. The effect of different locking screw length on tibia deformation and implant stress was minor. Conclusion: Thus, far-cortical locking screws and plates increase interfragmentary movement but the screw stress is relatively high. Increasing the protection time (partial weight duration) is suggested to decrease the risk of screw breakage in HTO through fixation with titanium far-cortical locking screws and plates.

原文English
文章編號35
期刊Journal of Orthopaedic Surgery and Research
14
發行號1
DOIs
出版狀態Published - 2019 一月 28

指紋

Osteotomy
Titanium
Tibia
Femur
Transplants
Weights and Measures
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

引用此文

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title = "Biomechanical investigation of the type and configuration of screws used in high tibial osteotomy with titanium locking plate and screw fixation",
abstract = "Background: To maintain the corrected alignment after high tibial osteotomy (HTO), fixation with titanium locking plate and screws is widely used in current practice; however, screw breakage is a common complication. Thus, this study was to investigate the mechanical stability of HTO with locking plate and various screw fixations, including the length as well as the type. Methods: A finite element (FE) model involving a distal femur, meniscus, and a proximal tibia with HTO fixed with a titanium locking plate and screws was created. The angle of the medial open wedge was 12°, and bone graft was not used. Two types of screws, namely conventional locking and far-cortical locking screws, with various lengths and configurations were used. At the proximal tibia, conventional locking screws with different lengths, 30 and 55 mm, were used; at the tibia shaft, different screw fixations including one-cortical, two-cortical, and far-cortical locking screws were used. Results: The use of far-cortical locking screw generated the highest equivalent stress on the screws, which was four times (from 137.3 to 541 MPa) higher than that of the one-cortical screw. Also, it led to the maximum deformation of the tibia and a greater gap deformation at the osteotomy site, which was twice (from 0.222 to 0.442 mm) larger than that of the one-cortical screw. The effect of different locking screw length on tibia deformation and implant stress was minor. Conclusion: Thus, far-cortical locking screws and plates increase interfragmentary movement but the screw stress is relatively high. Increasing the protection time (partial weight duration) is suggested to decrease the risk of screw breakage in HTO through fixation with titanium far-cortical locking screws and plates.",
author = "Chen, {Yen Nien} and Chih-Wei Chang and Li, {Chun Ting} and Chen, {Chih Hsien} and Chung, {Chi Rung} and Chih-Han Chang and Peng, {Yao Te}",
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T1 - Biomechanical investigation of the type and configuration of screws used in high tibial osteotomy with titanium locking plate and screw fixation

AU - Chen, Yen Nien

AU - Chang, Chih-Wei

AU - Li, Chun Ting

AU - Chen, Chih Hsien

AU - Chung, Chi Rung

AU - Chang, Chih-Han

AU - Peng, Yao Te

PY - 2019/1/28

Y1 - 2019/1/28

N2 - Background: To maintain the corrected alignment after high tibial osteotomy (HTO), fixation with titanium locking plate and screws is widely used in current practice; however, screw breakage is a common complication. Thus, this study was to investigate the mechanical stability of HTO with locking plate and various screw fixations, including the length as well as the type. Methods: A finite element (FE) model involving a distal femur, meniscus, and a proximal tibia with HTO fixed with a titanium locking plate and screws was created. The angle of the medial open wedge was 12°, and bone graft was not used. Two types of screws, namely conventional locking and far-cortical locking screws, with various lengths and configurations were used. At the proximal tibia, conventional locking screws with different lengths, 30 and 55 mm, were used; at the tibia shaft, different screw fixations including one-cortical, two-cortical, and far-cortical locking screws were used. Results: The use of far-cortical locking screw generated the highest equivalent stress on the screws, which was four times (from 137.3 to 541 MPa) higher than that of the one-cortical screw. Also, it led to the maximum deformation of the tibia and a greater gap deformation at the osteotomy site, which was twice (from 0.222 to 0.442 mm) larger than that of the one-cortical screw. The effect of different locking screw length on tibia deformation and implant stress was minor. Conclusion: Thus, far-cortical locking screws and plates increase interfragmentary movement but the screw stress is relatively high. Increasing the protection time (partial weight duration) is suggested to decrease the risk of screw breakage in HTO through fixation with titanium far-cortical locking screws and plates.

AB - Background: To maintain the corrected alignment after high tibial osteotomy (HTO), fixation with titanium locking plate and screws is widely used in current practice; however, screw breakage is a common complication. Thus, this study was to investigate the mechanical stability of HTO with locking plate and various screw fixations, including the length as well as the type. Methods: A finite element (FE) model involving a distal femur, meniscus, and a proximal tibia with HTO fixed with a titanium locking plate and screws was created. The angle of the medial open wedge was 12°, and bone graft was not used. Two types of screws, namely conventional locking and far-cortical locking screws, with various lengths and configurations were used. At the proximal tibia, conventional locking screws with different lengths, 30 and 55 mm, were used; at the tibia shaft, different screw fixations including one-cortical, two-cortical, and far-cortical locking screws were used. Results: The use of far-cortical locking screw generated the highest equivalent stress on the screws, which was four times (from 137.3 to 541 MPa) higher than that of the one-cortical screw. Also, it led to the maximum deformation of the tibia and a greater gap deformation at the osteotomy site, which was twice (from 0.222 to 0.442 mm) larger than that of the one-cortical screw. The effect of different locking screw length on tibia deformation and implant stress was minor. Conclusion: Thus, far-cortical locking screws and plates increase interfragmentary movement but the screw stress is relatively high. Increasing the protection time (partial weight duration) is suggested to decrease the risk of screw breakage in HTO through fixation with titanium far-cortical locking screws and plates.

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