초록
A biomechanical study was made to demonstrate the superior mechanical performance of the newly designed Miniplate staple to the conventional Coventry staple in high tibial osteotomy(HTO). Using twenty fresh porcine tibiae, the fixational strengh of the two different types of staple in HTO was compared. To minimize the error due to the specimen-to-specimen individuality, the bone mineral density of the tibiae was measured with a bone densitometry (Dual photon absorptionometer, Luner, USA) and those with $0.8\;{\sim}\;1.2\;gm/cm^2$ at the proximal tibia was used in the biomechanical test. Testing was performed on a material testing system (Autogram ET-5, Shimatzu, Japan) with aid of a commercial data processor (IBM 80386/ ASYST). Using two differant loading modes, 'pull-out' and 'push-out', the maximum resistant force required to release the staple from the substrate bone was recorded. In the pull-out test, ten non-osteotomized specimens were used and the staple was pullout by subjecting an axial tension on the head of the staple inserted. While in the pull-out test where ten tibiae osteotomized in the usual way of HTO were used, the staple was not directly loaded. In this testing, as a mimic condition of the natural knee, the distal part of the specimen tibia was pushed horizontally in order for the staple to be pulled out while the proximal tibia was fixed. The pull-out strength of Coventry staple and miniplate staple were found to be $27.88\;{\pm}\;5.12\;kgf$ and $182.47\;{\pm}\;32.75\;kgf$, respectively. The push-out strength of Coventry staple and miniplate staple were $18.40\;{\pm}\;4.47\;kgf$ and $119.95\;{\pm}\;19.06\;kgf$, respectively. The result revealed that miniplate staple had the pull-out/ push-out strength at least fivetimes higher than Coventry staple. Based on the measured data, it was believed that the newly designed miniplate staple could provide much better postoperative fixation in HTO. The postoerative application of long leg casting may not be needed after HTO surgery.