Abstract
BackgroundThis study aimed to investigate the biomechanical effect on the Takeuchi classification of lateral hinge fracture (LHF) after an opening wedge high tibial osteotomy (HTO).MethodsWe performed an FE simulation for type I, type II, and type III in accordance with the Takeuchi classification. The stresses on the bone and plate, wedge micromotion, and forces on ligaments were evaluated to investigate stress-shielding effect, plate stability, and biomechanical change, respectively, in three different types of LHF HTO and with the HTO without LHF model (non-LHF) models.ResultsThe greatest stress-shielding effect and wedge micromotion were observed in type II LHF (distal portion fracture). The type II and type III (lateral plateau fracture) models exhibited a reduction in PCL force and an increase in ACL force compared with the HTO without LHF model. However, the type I (osteotomy line fracture) and HTO without LHF models did not exhibit a significant biomechanical effect. This study demonstrates that Takeuchi type II and type III LHF models provide unstable structures compared with the type I and HTO without LHF models.ConclusionsHTO should be performed while considering a medial opening wedge HTO to avoid a type II and type III LHF as a potential complication.
Highlights
Medial opening wedge high tibial osteotomy (HTO) is a common treatment for younger and active older patients with medial compartment osteoarthritis and varus malalignment in the knee joint [1]
Intact model validation For Finite element (FE) model validation, the results from the experiment were compared with the FE subject
The results indicated an increase in anterior cruciate ligament (ACL) force and a decrease in posterior cruciate ligament (PCL) force in the type II and type III lateral hinge fracture (LHF) models compared with the type I and HTO model without LHF (non-LHF) models
Summary
Medial opening wedge high tibial osteotomy (HTO) is a common treatment for younger and active older patients with medial compartment osteoarthritis and varus malalignment in the knee joint [1]. This procedure is increasingly used because of its benefits for closing wedge osteotomy, such as achieving more predictable correction, maintaining bone stock, and avoiding osteotomy of the fibula, which may compromise the peroneal nerve; it may be associated with delayed unions and nonunions [2,3,4,5]. This study aimed to investigate the biomechanical effect on the Takeuchi classification of lateral hinge fracture (LHF) after an opening wedge high tibial osteotomy (HTO)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
