Authors
Yoshiya Nibe, Tsuneari Takahashi, Tomohiro Matsumura, Kohei Watanabe, Takumi Matsumoto
Published in
BMC musculoskeletal disorders. Jul 13, 2026. Epub Jul 13, 2026.
Abstract
Medial opening wedge high tibial osteotomy (MOWHTO) is a standard treatment for knee osteoarthritis. However, lateral hinge fractures occur in 19-25% of cases, with Type 2 fractures causing significant instability. While lateral plating is recommended, it requires an additional incision. This study investigated whether medial-only fixation using a 4.5 mm cortical screw inserted into the Tomofix plate's oval hole could provide sufficient stability for Type 2 hinge fractures.
Twelve fresh pig knees underwent MOWHTO with a 6 mm opening. They were divided into two groups: Group I (intact lateral hinge) and Group F (induced Type 2 hinge fracture fixed with a medial 4.5 mm cortical screw in the Tomofix oval hole). Specimens were subjected to 2,000 cycles of axial loading (up to 800 N), representing early postoperative partial weight-bearing conditions. Displacement during cycling, and changes in the anterior gap (AG), posterior gap (PG), and posterior tibial slope (PTS) were measured.
Group F exhibited significantly greater displacement during cyclic loading compared to Group I (p = 0.0029), indicating significantly greater construct displacement. There were no statistically significant differences between the groups regarding changes in AG (p = 0.15), PG (p = 0.53), or PTS (p = 0.22).
Fixation with a 4.5 mm cortical screw in the Tomofix oval hole did not restore stability comparable to an intact lateral hinge for Type 2 lateral hinge fractures during an ex vivo porcine MOWHTO model.
PMID:
42437910
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.
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