How to fix a tibial tubercle osteotomy with distalisation : A finite element analysis

Guneri, Bulent and Kose, Ozkan and Celik, H Kursat and Cakar, Albert and Tasatan, Ersin and Rennie, Allan (2022) How to fix a tibial tubercle osteotomy with distalisation : A finite element analysis. Knee, 37. pp. 132-142. ISSN 0968-0160

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Abstract

Background: Antero-medialisation osteotomy combined with a distalisation procedure may require a more stable fixation as the osteotomy fragment loses both proximal and distal support. This finite element analysis aimed to compare the mechanical behaviour of different fixation techniques in tibial tubercle antero-medialisation osteotomy combined with distalisation procedure. Methods: Tibial tubercle osteotomy combined with distalisation was modelled based on computerised tomography data, which were acquired from a patient with patellar instability requiring this procedure. Six different fixation configurations with two 3.5-mm cortical screws (1), two 4.5-mm cortical screws (2), three 3.5-mm cortical screws (3), three 4.5-mm cortical screws (4), three 3.5-mm screws with 1/3 tubular plate (5), and four 3.5-mm screws with 1/3 tubular plate (6) were created. A total of 1654 N of force was applied to the patellar tendon footprint on the tibial tubercle. Sliding, gap formation, and total deformation between the osteotomy components were analyzed. Results: Maximum sliding (0.660 mm), gap formation (0.661 mm), and displacement (1.267 mm) were seen with two 3.5-mm screw fixation, followed by two 4.5-mm screws, three 3.5-mm screws, and three 4.5-mm screws, respectively, in the screw-only group. Overall, the minimum displacement was observed with the four 3.5-mm screws with 1/3 tubular plate fixation model. Conclusions: Plate fixation might be recommended for tibial tubercle antero-medialisation osteotomy combined with distalisation procedure because it might allow early active range of motion exercises and weight-bearing.

Item Type:

Journal Article

Journal or Publication Title:

Knee

Additional Information:

This is the author’s version of a work that was accepted for publication in The Knee. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Knee, 37, 2022 DOI: 10.1016/j.knee.2022.06.002

Uncontrolled Keywords:

/dk/atira/pure/subjectarea/asjc/2700/2732

Subjects:

?? tibial tubercle osteotomyfulkerson osteotomydistalisationscrew fixationplate fixationbiomechanicsorthopedics and sports medicine ??

Departments:

Faculty of Science and Technology > Engineering

ID Code:

174164

Deposited By:

ep_importer_pure

Deposited On:

09 Aug 2022 09:25

Refereed?:

Yes

Published?:

Published

Last Modified:

22 Nov 2023 00:50

URI:

https://eprints.lancs.ac.uk/id/eprint/174164