{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:32:06Z","timestamp":1788258726837,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,10,7]],"date-time":"2009-10-07T00:00:00Z","timestamp":1254873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Open\u2010wedge high tibial osteotomy (HTO) is becoming increasingly popular for the treatment of varus gonarthrosis in the active patient. The various implants used in HTO differ with regard to its design, the fixation stability and osteotomy technique. It is assumed that the combination of a plate fixator with a biplanar, v\u2010shaped osteotomy supports bone healing. So far, there are no biomechanical studies that quantify the stabilizing effect of a biplanar versus uniplanar osteotomy. We hypothesized that a significant increase in primary stability of bone\u2010implant constructs is achieved when using a biplanar as opposed to a uniplanar osteotomy. Twenty\u2010four fresh\u2010frozen human tibiae were mounted in a metal cylinder, and open\u2010wedge osteotomy (12\u00a0mm wedge size) was performed in a standardized fashion. Proximal and distal tibial segments were marked with tantalum markers of 0.8\u00a0mm diameter. Two different plates with locking screws were used for fixation: a short spacer plate (group 1, <jats:italic>n<\/jats:italic> = 12) and a plate fixator (group 2, <jats:italic>n<\/jats:italic> = 12). In six specimens of each group, a biplanar V\u2010shaped osteotomy with a 110\u00b0 angulated anterior cut behind the tuberosity parallel to the ventral tibial shaft axis was performed. In the remaining six specimens of each group, a simple uniplanar osteotomy was performed in an oblique fashion. Axial compression of the tibiae was performed using a material testing machine under standardized alignment of the loading axis. Load\u2010controlled cyclical staircase loading tests were performed. The specimens were radiographed simultaneously in two planes together with a biplanar calibration cage in front of a film plane with and without load after each subcycle. Radiostereometry allowed for serial quantification of plastic and elastic micromotion at the osteotomy site reflecting the stability provided by the combination of implant and osteotomy technique. No significant additional stabilizing effect of a biplanar osteotomy in craniocaudal and mediolateral plane was found. However, additional stability was achieved in anteroposterior (AP) and all rotational planes in those specimens fixated with a short spacer plate. In this biomechanical set\u2010up with axial load, the additional stabilizing effect of a biplanar osteotomy did not come into effect in the presence of a long and rigid plate fixator. However, biplanar osteotomy increased the fixation stability significantly in AP and rotational planes when a short spacer plate was used. Clinically, the biplanar osteotomy promotes bone healing regardless of the implant used. Biomechanically, biplanar osteotomy is advantageous for shorter plate designs to increase primary stability of the bone\u2010implant construct.<\/jats:p>","DOI":"10.1007\/s00167-009-0929-3","type":"journal-article","created":{"date-parts":[[2009,10,6]],"date-time":"2009-10-06T07:55:43Z","timestamp":1254815743000},"page":"204-211","source":"Crossref","is-referenced-by-count":57,"title":["Effect of a biplanar osteotomy on primary stability following high tibial osteotomy: a biomechanical cadaver study"],"prefix":"10.1002","volume":"18","author":[{"given":"Dietrich","family":"Pape","sequence":"first","affiliation":[{"name":"Centre de l'Appareil Locomoteur de Medecine du Sport et de Prevention Centre Hospitalier de Luxembourg Clinique d Eich 78, rue d Eich 1460 Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Lorbach","sequence":"additional","affiliation":[{"name":"Centre de l'Appareil Locomoteur de Medecine du Sport et de Prevention Centre Hospitalier de Luxembourg Clinique d Eich 78, rue d Eich 1460 Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmitz","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Duisburg Gro\u00dfenbaumer Allee 250 47249 Duisburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00fcder C.","family":"Busch","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Anatomie Universit\u00e4t zu L\u00fcbeck Ratzeburger Allee 160 23538 L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolien","family":"Van Giffen","sequence":"additional","affiliation":[{"name":"Centre de l'Appareil Locomoteur de Medecine du Sport et de Prevention Centre Hospitalier de Luxembourg Clinique d Eich 78, rue d Eich 1460 Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Seil","sequence":"additional","affiliation":[{"name":"Centre de l'Appareil Locomoteur de Medecine du Sport et de Prevention Centre Hospitalier de Luxembourg Clinique d Eich 78, rue d Eich 1460 Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter M.","family":"Kohn","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Universit\u00e4tsklinik Homburg Universit\u00e4t des Saarlandes Kirrbergerstrasse 66421 Homburg Saar Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,10,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010005\u20100690\u20101"},{"key":"e_1_2_7_3_1","volume-title":"Statistical methods for medical and biological students","author":"Dahlberg 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