Effect of plate position on tibial displacement and posterior tibial slope after cyclic loading in medial open wedge high tibial osteotomy: A biomechanical study using porcine tibia

Abstract

Background: Medial open wedge high tibial osteotomy is currently the most common osteotomy, but its complication is an increased posterior tibial slope over time. However, no study has clarified whether the plate position of medial open wedge high tibial osteotomy could reduce the increase in posterior tibial slope after cyclic loading.

Methods: Fourteen porcine bones were biomechanically evaluated by performing medial open wedge high tibial osteotomy and placing TOMOFIX medially and anteromedially. Cyclic testing was performed to investigate the posterior tibial slope over time for medial open wedge high tibial osteotomy with medial or anteromedial plate. The displacement along the mechanical axis during cyclic testing from 10 to 100th, 100-500th, 500-1000th, 1000-1500th, and 1500-2000th cycles, and changes in anterior and posterior gaps after 2000 cycles were compared between plate position.

Findings: There were no significant differences in displacement. A significant difference was found in posterior gap changes (-0.20 ± 0.84 mm in group of using medial plate, 1.07 ± 0.82 mm in group of using anteromedial plate) (P = 0.014), but none was found in anterior gap changes.

Interpretation: Medial plate placement in medial open wedge high tibial osteotomy resulted in significantly less increased posterior tibial slope than anteromedial plate placement after cyclic loading.

Keywords: Biomechanical study; High tibial osteotomy; Locking plate; Porcine tibia; Posterior tibial slope.