{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:27:26Z","timestamp":1776277646721,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T00:00:00Z","timestamp":1573084800000},"content-version":"vor","delay-in-days":310,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T00:00:00Z","timestamp":1573084800000},"content-version":"vor","delay-in-days":310,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to assess the mechanical static and fatigue strength provided by the FlexitSystem plate in medial opening wedge high tibial osteotomies (MOWHTO), and to compare it to six previously tested implants: the TomoFix small stature, the TomoFix standard, the ContourLock, the iBalance, the second generation PEEKPower and the size 2 Activmotion. Thus, this will provide surgeons with data that will help in the choice of the most appropriate implant for MOWHTO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Six fourth\u2010generation tibial bone composites underwent a MOWHTO and each was fixed using six FlexitSystem plates, according to standard techniques. The same testing procedure that has already been previously defined, used and published, was used to investigate the static and dynamic strength of the prepared bone\u2010implant constructs. The test consisted of static loading and cyclical loading for fatigue testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During static testing, the group constituted by the FlexitSystem showed a fracture load higher than the physiological loading of slow walking (3.7 kN\u2009&gt;\u20092.4 kN). Although this fracture load was relatively small compared to the average values for the other Implants from our previous studies, except for the TomoFix small stature and the Contour Lock. During fatigue testing, FlexitSystem group showed the smallest stiffness and higher lifespan than the TomoFix and the PEEKPower groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The FlexitSystem plate showed sufficient strength for static loading, and average fatigue strength compared to the previously tested implants. Full body dynamic loading of the tibia after MOWHTO with the investigated implants should be avoided for at least 3 weeks. Implants with a wider T\u2010shaped proximal end, positioned onto the antero\u2010medial side of the tibia head, or inserted in the osteotomy opening in a closed\u2010wedge construction, provided higher mechanical strength than implants with small a T\u2010shaped proximal end, centred onto the medial side of the tibia head.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-019-0209-1","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T07:03:27Z","timestamp":1573110207000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Mechanical strength of a new plate compared to six previously tested opening wedge high tibial osteotomy implants"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1569-2893","authenticated-orcid":false,"given":"Arnaud","family":"Diffo Kaze","sequence":"first","affiliation":[{"name":"Faculty of Science Technology and Communication University of Luxembourg 6, rue R. Coudenhove\u2010Kalergi L\u20101359 Luxembourg Luxembourg"},{"name":"Department of Orthopedic Surgery Centre Hospitalier de Luxembourg L\u20101460 Luxembourg Luxembourg"},{"name":"Cartilage Net of the Greater Region 66421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Maas","sequence":"additional","affiliation":[{"name":"Faculty of Science Technology and Communication University of Luxembourg 6, rue R. 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Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Seil","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Centre Hospitalier de Luxembourg L\u20101460 Luxembourg Luxembourg"},{"name":"Cartilage Net of the Greater Region 66421 Homburg\/Saar Germany"},{"name":"Sports Medicine Research Laboratory Public Research Centre for Health Centre M\u00e9dical de la Fondation Norbert Metz 76 rue d\u2019Eich L\u20101460 Luxembourg Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"van Heerwaarden","sequence":"additional","affiliation":[{"name":"Department of Sport Exercise &amp; Health University of Winchester Sparkford Road S022 4NR Winchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietrich","family":"Pape","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Centre Hospitalier de Luxembourg L\u20101460 Luxembourg 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April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The realisation of the tests with the FlexitSystem plate was supported by the company Neosteo, which offered the plates and the screws. 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