Research article

Augmentation of tibial plateau fractures with Trabecular Metal™: a biomechanical study

Benoit Benoit¹ , Zhim Fouad² , George-Henri Laflamme¹ , Dominique Rouleau¹ and G Yves Laflamme¹

¹  Orthopedic Surgery, Department of Surgery, Université de Montréal Hôpital du Sacré-Cœur de Montréal, 5400, boul. Gouin Ouest, Room C-2080 Montréal, Québec H4J 1C5, Canada

²  Institut de Génie Biomédical, École Polytechnique, CP6079 Succ. Centre-Ville Montréal, Québec, H3C 3A7, Canada

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Journal of Orthopaedic Surgery and Research 2009, 4:37doi:10.1186/1749-799X-4-37

Published:	22 September 2009

Abstract

Background

Restoration and maintenance of the plateau surface are the key points in the treatment of tibial plateau fractures. Any deformity of the articular surface jeopardizes the future of the knee by causing osteoarthritis and axis deviation. The purpose of this study is to evaluate the effect of Trabecular Metal (porous tantalum metal) on stability and strength of fracture repair in the central depression tibial plateau fracture.

Method

Six matched pairs of fresh frozen human cadaveric tibias were fractured and randomly assigned to be treated with either the standard of treatment (impacted cancellous bone graft stabilized by two 4.5 mm screws under the comminuted articular surface) or the experimental method (the same screws supporting a 2 cm diameter Trabecular Metal (TM) disc placed under the comminuted articular surface). Each tibia was tested on a MTS machine simulating immediate postoperative load transmission with 500 Newton for 10,000 cycles and then loaded to failure to determine the ultimate strength of the construct.

Results

The trabecular metal construct showed 40% less caudad displacement of the articular surface (1, 32 ± 0.1 mm vs. 0, 80 ± 0.1 mm) in cyclic loading (p < 0.05). Its mechanical failure occurred at a mean of 3275 N compared to 2650 N for the standard of care construct (p < 0, 05).

Conclusion

The current study shows the biomechanical superiority of the trabecular metal construct compared to the current standard of treatment with regards to both its resistance to caudad displacement of the articular surface in cyclic loading and its strength at load to failure.