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  • Tibial Tubercle Osteotomy - Published - for PURE

    Rights statement: 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

    Accepted author manuscript, 2.87 MB, PDF document

    Embargo ends: 29/06/23

    Available under license: CC BY-NC-ND: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

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

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Published
  • Bulent Guneri
  • Ozkan Kose
  • H Kursat Celik
  • Albert Cakar
  • Ersin Tasatan
  • Allan Rennie
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<mark>Journal publication date</mark>31/08/2022
<mark>Journal</mark>Knee
Volume37
Number of pages11
Pages (from-to)132-142
Publication StatusPublished
Early online date29/06/22
<mark>Original language</mark>English

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.

Bibliographic note

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