{"title":"In Vitro Assessment of Compression Patterns Using Different Methods to Achieve Interfragmentary Compression during Tibial Plateau Levelling Osteotomy.","authors":"Rodrigo Alvarez, Claudio Motta, Diogo Miraldo","doi":"10.1055/s-0043-1778132","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong> The aim of this study was to evaluate and characterize different methods to achieve interfragmentary compression during tibial plateau levelling osteotomy (TPLO).</p><p><strong>Study design: </strong> TPLO was performed in 20 canine tibia models (Sawbones, Vashon, Washington, United States) using 3D-printed guides for standardization. Interfragmentary compression was assessed using pressure-sensitive films (Prescale, Fujifilm, Atherstone, United Kingdom). Seven compression methods were tested: (1) Kern bone holding forceps clamping the craniodistal aspect of the TPLO plate to the caudal aspect of the tibia (K); (2) using the distal TPLO plate dynamic compression hole (P); (3) pointed bone reduction forceps engaging the caudal aspect of the proximal bone fragment and the cranial aspect of the tibial crest (F); (4) K + P; (5) K + F; (6) F + P; and (7) K + F + P. Five measurements were obtained for each method, and each bone model was used for two measurements (single method, ± plate). The interfragmentary surface was digitalized and divided into quadrants for standardization and pixel density calculation: Q1, craniomedial; Q2, craniolateral; Q3, caudomedial; and Q4, caudolateral. One-way analysis of variance (ANOVA) and post hoc tests were used for statistical analysis.</p><p><strong>Results: </strong> Mean pressures per quadrant differed significantly between methods (<i>p</i> < 0.001). Methods K, F, and P produced more craniomedial, craniolateral, and caudal compression, respectively. Method K resulted in loss of caudal compression (<i>p</i> < 0.001). Method F + P provided the most even distribution of high interfragmentary compression forces. The addition of method K to this construct (K + F + P) marginally increased cranial compression (<i>p</i> = 0.189 for Q1; <i>p</i> < 0.001 for Q2), but reduced compression caudally (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> Method F + P provided more even interfragmentary compression. If method K were used, then combined use with method F + P would be recommended.</p>","PeriodicalId":51204,"journal":{"name":"Veterinary and Comparative Orthopaedics and Traumatology","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary and Comparative Orthopaedics and Traumatology","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1055/s-0043-1778132","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/8 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: The aim of this study was to evaluate and characterize different methods to achieve interfragmentary compression during tibial plateau levelling osteotomy (TPLO).
Study design: TPLO was performed in 20 canine tibia models (Sawbones, Vashon, Washington, United States) using 3D-printed guides for standardization. Interfragmentary compression was assessed using pressure-sensitive films (Prescale, Fujifilm, Atherstone, United Kingdom). Seven compression methods were tested: (1) Kern bone holding forceps clamping the craniodistal aspect of the TPLO plate to the caudal aspect of the tibia (K); (2) using the distal TPLO plate dynamic compression hole (P); (3) pointed bone reduction forceps engaging the caudal aspect of the proximal bone fragment and the cranial aspect of the tibial crest (F); (4) K + P; (5) K + F; (6) F + P; and (7) K + F + P. Five measurements were obtained for each method, and each bone model was used for two measurements (single method, ± plate). The interfragmentary surface was digitalized and divided into quadrants for standardization and pixel density calculation: Q1, craniomedial; Q2, craniolateral; Q3, caudomedial; and Q4, caudolateral. One-way analysis of variance (ANOVA) and post hoc tests were used for statistical analysis.
Results: Mean pressures per quadrant differed significantly between methods (p < 0.001). Methods K, F, and P produced more craniomedial, craniolateral, and caudal compression, respectively. Method K resulted in loss of caudal compression (p < 0.001). Method F + P provided the most even distribution of high interfragmentary compression forces. The addition of method K to this construct (K + F + P) marginally increased cranial compression (p = 0.189 for Q1; p < 0.001 for Q2), but reduced compression caudally (p < 0.001).
Conclusion: Method F + P provided more even interfragmentary compression. If method K were used, then combined use with method F + P would be recommended.
研究目的本研究旨在评估和描述在胫骨平台平整截骨术（TPLO）中实现节段间压迫的不同方法：研究设计：在20个犬胫骨模型（Sawbones，Vashon，Washington，United States）中使用3D打印的标准化导板进行TPLO。使用压敏胶片（Prescale，Fujifilm，Atherstone，英国）评估节间压缩情况。测试了七种压缩方法：(1) Kern 持骨钳将 TPLO 钢板的头端向胫骨尾端夹紧（K）；(2) 使用 TPLO 钢板远端动态压缩孔（P）；(3) 尖头缩骨钳将近端骨片的尾端与胫骨嵴的头端接合（F）；(4) K + P；(5) K + F；(6) F + P；(7) K + F + P。每种方法进行五次测量，每个骨模型进行两次测量（单一方法，±平板）。为了标准化和计算像素密度，将骨节间表面数字化并划分为几个象限：Q1，颅内侧；Q2，颅外侧；Q3，尾内侧；Q4，尾外侧。统计分析采用单因素方差分析（ANOVA）和事后检验：结果：各象限的平均压力在不同方法之间存在显著差异（Q1 的 p p p = 0.189；Q2 的 p p p = 0.189；Q3 的 p p p = 0.189；Q4 的 p p p = 0.189）：方法 F + P 提供了更均匀的节段间压力。如果使用 K 方法，则建议结合使用 F + P 方法。
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