title: Biomechanical comparison of two alternative tibial plateau leveling osteotomy plates with the original standard in an axially loaded gap model: an in vitro study.
abstract: OBJECTIVE
  To compare the axial compression stiffness of osteotomized canine tibiae stabilized with Slocum, Securos, or Synthes plates after a tibial plateau leveling osteotomy (TPLO) procedure.
  
  
  METHODS
  In vitro, paired comparison of cadaveric tibial constructs subjected to mechanical testing under an axial load.
  
  
  METHODS
  Canine tibiae (n=16 pairs) from skeletally mature male and female dogs of various breeds (18-55 kg).
  
  
  METHODS
  Tibial pairs (n=16) were randomly assigned to 1 of 2 study cohorts (n=8 pairs/cohort): cohort 1, tibial osteotomy stabilization with a Slocum or a Securos plate, or cohort 2, tibial osteotomy stabilization with a Slocum or a Synthes plate. One tibia from each pair was stabilized with 1 of each plate design assigned to the cohort after TPLO. A 3.2 mm osteotomy gap was maintained during plate application in all constructs. Load and axial displacement were recorded while constructs were loaded to 2000 N in axial compression. Failure loads were not reported because no distinct yield point or failure point was evident within the load range for many specimens. Failure modes were recorded for each construct, and photographs of typical failures were obtained. Stiffness (N/mm) was calculated from load-displacement curves. Paired comparisons of mean stiffness were performed within study groups using a paired t-test. Significance was set at P<.05.
  
  
  RESULTS
  The mean construct stiffnesses for the Slocum (383+/-183 N/mm) and Securos (258+/-64.1 N/mm) constructs were not significantly different (P=.164; power=0.566). The mean construct stiffness for the Synthes constructs (486+/-91.0 N/mm) was significantly greater than that of the Slocum constructs (400+/-117 N/mm); P=.0468. Modes of failure for the Slocum (16/16) and Securos (8/8) constructs included plastic deformation of the implant with valgus deformity combined with fibular luxation (2/16 Slocum; 1/8 Securos) or fibular fracture (2/16 Slocum; 4/8 Securos). Most Synthes constructs underwent elastic deformation (7/8). One Synthes construct fractured in the sagittal plane through the tibial plateau depression at the point of load application.
  
  
  CONCLUSIONS
  The Slocum and Securos plate/tibia construct have similar stiffness, whereas the Synthes/tibia constructs are significantly stiffer than the Slocum/tibia constructs. Modes of fixation failure observed in this model were consistent with TPLO fixation failures observed clinically.
  
  
  CONCLUSIONS
  Construct stiffness in axial load varies with implant type. Implants that confer higher stiffness to the construct may result in greater fixation stability in tibial metaphyseal osteotomies.
authors.affiliation: The Veterinary Orthopedic Research Laboratory, and the Orthopaedic BioMaterials Laboratory, TheOhio State University, Columbus, OH, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kloc
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kowaleski
authors.forename: Alan S
authors.initials: AS
authors.lastname: Litsky
authors.forename: Nancy O
authors.initials: NO
authors.lastname: Brown
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Johnson
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D001860:Bone Plates / Q000662:veterinary; D002102:Cadaver; D019245:Compressive Strength; D004285:Dogs / Q000293:injuries / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D008297:Male; D008422:Materials Testing / Q000662:veterinary*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D011897:Random Allocation; D013264:Stifle / Q000601:surgery*; D013314:Stress, Mechanical; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome