Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep;27(3):181-6.
doi: 10.5792/ksrr.2015.27.3.181. Epub 2015 Sep 1.

Biomechanical Study of the Fixation Plates For Opening Wedge High Tibial Osteotomy

Free PMC article

Biomechanical Study of the Fixation Plates For Opening Wedge High Tibial Osteotomy

Kug Jin Kim et al. Knee Surg Relat Res. .
Free PMC article


Purpose: The purpose of this study was to compare the mechanical stability of three types of plate systems for opening wedge high tibial osteotomy.

Materials and methods: Forty-eight fresh frozen porcine tibia specimens were assigned to three different fixation device groups: Aescular group (16 specimens) was fixed with Aescular plates; Puddu group (16 specimens) with a Puddu plate, and TomoFix group (16 specimens) with a TomoFix plate. We compared axial displacements under compression loads from 200 to 2,000 N and maximal loads at failure among 8 specimens per group. We also compared displacements under cyclic load after 100 cycles at a compressive load of 2,000 N among 8 specimens per group.

Results: In all three groups, displacement under compression load increased with the increase in the axial compressive load; however, no significant intergroup differences were observed in the mean values under tested loading conditions. The mean maximal loads at failure were not significantly different (6,055, 6,798, and 6,973 N in the Aescular, Puddu, and TomoFix groups, respectively; p=0.41). While the TomoFix group showed less extension and strain during the cyclic load test, the mean values showed no significant differences among groups.

Conclusions: All three plate systems were found to provide fixation stability suitable for bearing axial compression and cyclic loads while walking.

Keywords: Biomechanical study; Fixation plate; High tibial osteotomy; Knee; Opening wedge.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.


Fig. 1
Fig. 1. Three plates for fixation of open wedge high tibial osteotomy: (A) Aescular plate, (B) Puddu plate, and (C) TomoFix plate.
Fig. 2
Fig. 2. Testing arrangement with axial loading of opening wedge high tibial osteotomy using mechanical testing system (Instron).
Fig. 3
Fig. 3. (A) Graph of axial compression load test. Failure load was defined as a drop of more than 30% of peak pressure. (B) Graph of compression/extension cyclic load test (2,000 N compression load).
Fig. 4
Fig. 4. (A) Degree of displacement at the time of failure. (B) Maximum load at the time of failure.

Similar articles

See all similar articles

Cited by 4 articles


    1. Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ. Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg Br. 2008;90:1548–1557. - PubMed
    1. Backstein D, Meisami B, Gross AE. Patella baja after the modified Coventry-Maquet high tibial osteotomy. J Knee Surg. 2003;16:203–208. - PubMed
    1. Flecher X, Parratte S, Aubaniac JM, Argenson JN. A 12-28-year followup study of closing wedge high tibial osteotomy. Clin Orthop Relat Res. 2006;452:91–96. - PubMed
    1. Majima T, Yasuda K, Katsuragi R, Kaneda K. Progression of joint arthrosis 10 to 15 years after high tibial osteotomy. Clin Orthop Relat Res. 2000;(381):177–184. - PubMed
    1. Odenbring S, Tjornstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhoj T, Svanstrom A. Function after tibial osteotomy for medial gonarthrosis below aged 50 years. Acta Orthop Scand. 1989;60:527–531. - PubMed

LinkOut - more resources