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. 2009 Sep 22:4:37.
doi: 10.1186/1749-799X-4-37.

Augmentation of tibial plateau fractures with Trabecular Metal: a biomechanical study

Benoit Benoit  1 , Zhim Fouad, George-Henri Laflamme, Dominique Rouleau, G Yves Laflamme
Affiliations

Augmentation of tibial plateau fractures with Trabecular Metal: a biomechanical study

Benoit Benoit et al. J Orthop Surg Res. .

Abstract

Background: Restoration and maintenance of the plateau surface are the key points in the treatment of tibial plateau fractures. Any deformity of the articular surface jeopardizes the future of the knee by causing osteoarthritis and axis deviation. The purpose of this study is to evaluate the effect of Trabecular Metal (porous tantalum metal) on stability and strength of fracture repair in the central depression tibial plateau fracture.

Method: Six matched pairs of fresh frozen human cadaveric tibias were fractured and randomly assigned to be treated with either the standard of treatment (impacted cancellous bone graft stabilized by two 4.5 mm screws under the comminuted articular surface) or the experimental method (the same screws supporting a 2 cm diameter Trabecular Metal (TM) disc placed under the comminuted articular surface). Each tibia was tested on a MTS machine simulating immediate postoperative load transmission with 500 Newton for 10,000 cycles and then loaded to failure to determine the ultimate strength of the construct.

Results: The trabecular metal construct showed 40% less caudad displacement of the articular surface (1, 32 +/- 0.1 mm vs. 0, 80 +/- 0.1 mm) in cyclic loading (p < 0.05). Its mechanical failure occurred at a mean of 3275 N compared to 2650 N for the standard of care construct (p < 0, 05).

Conclusion: The current study shows the biomechanical superiority of the trabecular metal construct compared to the current standard of treatment with regards to both its resistance to caudad displacement of the articular surface in cyclic loading and its strength at load to failure.

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Figures

Figure 1
Figure 1
Standard Construct with impacted cancellous bone graft.
Figure 2
Figure 2
Trabecular Metal Construct with no graft.
Figure 3
Figure 3
End result for both construct with anatomic reduction of the osteochondral fragments.
Figure 4
Figure 4
Diagram of the compression testing apparatus, MTS Bionix™ Test system 858.
Figure 5
Figure 5
Dynamic Loading: Average depression in the constructs during cyclic loading. Maximum mean displacement was 1.32 ± 0.1 mm [1.01 to 1.51 mm] for the standard construct group and 0.80 ± 0.1 mm [0.73 to 0.95 mm] for the TM construct group (P < 0.05).
Figure 6
Figure 6
Static Loading: Load versus displacement curves for specimens with trabecular implant and conventional technique.
See this image and copyright information in PMC

References

    1. Benirschke SK, Swiontkowski MF. Knee. In: Hansen S, Swiontkowski MF, editor. Orthopaedic trauma protocols. 1. New York: Raven Press; 1993.
    1. Karunakar MA, Egol KA, Peindl R, Harrow ME, Bosse MJ, Kellam JF. Split depression tibial plateau fractures: A biomechanical study. Journal Orthop Trauma. 2002;16:172–7. doi: 10.1097/00005131-200203000-00006. - DOI - PubMed
    1. Twaddle BC, Knutson C, Tencer AF, et al. Biomechanical testing of buttress and raft plate fixation of lateral tibial plateau fractures. Proceedings of the 64th Annual Meeting of the American Academy of Orthopaedic Surgeons: Atlanta, Georgia. 1997.
    1. Russel TA, Leighton RK, Bucholz RW. The Gold Standard in Tibial Plateau Fractures? A Prospective Multicenter Randomized Study of AIBG vs Alpha - BSM. Proceedings of the OTA Meeting, Florida. 2004.
    1. Yetkinler DN, McClellan RT, Reindel ES, Carter D, Poser RD. Biomechanical comparison of conventional open reduction and internal fixation versus calcium phosphate cement fixation of a central depressed tibial plateau fracture. J Orthop Trauma. 2001;15:197–206. doi: 10.1097/00005131-200103000-00009. - DOI - PubMed

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