高位けい骨骨切り術における新しいＢｒａｄｅ Ｓｔａｐｌｅの固定力に関する検討

Abstract

Loss of correction due to lack of fixation rigidity of staples still remains a problem after high tibial oeteotomy (HTO). Ogata has developed a new staple design which is characterized by the blade-like inserting portion and the addition of one cortical screw at the distal portion. After using this staple, we concluded that the staple should be placed as proximally as possible in the upper tibial fragment to accomplish staple fixation before. Varus deformation and destruction of the lateral joint due to recurrence sometimes requires TKA in patients after HTO. We developed a new staple based on Ogata's design, which is characterized by the addition of one cancellous screw at the proximal portion. This study was carried out to compare the fixation rigidity of Ogata's staple with our new staple. The proximal part of the tibia was mounted, and bending load was applied antero-posteriorly and latero-medially at the distal point to the osyeotomy site by using a mechanical testing machine. Two groups were compared statistically. In the antero-posterior loading test, the maximum load before breakage was 81.7±20.8N in Ogata's staple, and 174.9±34.8N in our modified design. In the latero-medial loading test, the maximum load before breakage was 528.8±118.4N in Ogata's staple, and 815.8±222.7N in our design. The results of this study showed that our staple has adequate fixation rigidity, which prevents loosening of the staple.