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Axial and torsional stability of an improved single-plane and a new bi-plane osteotomy technique for supracondylar femur osteotomies

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

An Erratum to this article was published on 01 March 2011

Abstract

Purpose

An important disadvantage of the standard medial closing-wedge distal femur osteotomy for lateral compartment osteoarthritis of the knee is the immediate effects on the extensor mechanism function. Therefore, a novel bi-plane osteotomy technique was developed. The stability and stiffness of this newly developed technique and a modification of the proximal screw configuration were tested in a composite femur model and compared to the standard single-plane technique. Research question was if the new bi-plane technique and/or modified screw configuration would improve the stability and stiffness of the construct.

Methods

In 12 femurs, motion at the osteotomy under axial and torsion loading was measured using a 3D motion analysis system. All were subsequently tested to failure. The data recorded were used to calculate stability and stiffness of the constructs.

Results

The stability and stiffness were highest in the bi-plane technique under axial loads, but were lower under torsional loading, compared to the single-plane technique. The screw configuration modification improved axial stability and stiffness, but had no influence on torsional stability.

Conclusion

In replicate femurs, the new bi-plane technique improved axial stability, but in contrast to what was theorized, decreased torsional stability, compared to the single-plane technique. The addition of a bi-cortical screw proximally improved stability under axial loading, but not torsion. Further clinical testing will have to prove if early full weight bearing using the new bi-plane technique is possible.

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Authors and Affiliations

  1. Department of Orthopaedics, Limb Deformity Reconstruction Unit, Sint Maartenskliniek, P.O. Box 8000, 3440 JD, Woerden, The Netherlands

    J.-M. Brinkman & R. J. van Heerwaarden

  2. Laboratory for Biomechanics and Biomaterials, Orthopaedic Department, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hannover, Germany

    C. Hurschler

  3. Department of Orthopaedic Surgery, Privatklinik Sonnmatt, Hemschlenstrasse, 6000, Lucerne 15, Switzerland

    A. E. Staubli

Authors
  1. J.-M. Brinkman
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  2. C. Hurschler
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  3. A. E. Staubli
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  4. R. J. van Heerwaarden
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Corresponding author

Correspondence to J.-M. Brinkman.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00167-011-1450-z

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Brinkman, JM., Hurschler, C., Staubli, A.E. et al. Axial and torsional stability of an improved single-plane and a new bi-plane osteotomy technique for supracondylar femur osteotomies. Knee Surg Sports Traumatol Arthrosc 19, 1090–1098 (2011). https://doi.org/10.1007/s00167-010-1349-0

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