Static and fatigue strength of a novel anatomically contoured implant compared to five current open-wedge high tibial osteotomy plates

Arnaud Diffo Kaze*, Stefan Maas, James Belsey, Alexander Hoffmann, Dietrich Pape

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    11 Citations (Scopus)


    Background: The purpose of the present study was to compare the mechanical static and fatigue strength of the size 2 osteotomy plate “Activmotion” with the following five other common implants for the treatment of medial knee joint osteoarthritis: the TomoFix small stature, the TomoFix standard, the Contour Lock, the iBalance and the second generation PEEKPower. Methods: Six fourth-generation tibial bone composites underwent a medial open-wedge high tibial osteotomy (HTO), according to standard techniques, using size 2 Activmotion osteotomy plates. All bone-implant constructs were subjected to static compression load to failure and load-controlled cyclic fatigue failure testing, according to a previously defined testing protocol. The mechanical stability was investigated by considering different criteria and parameters: maximum forces, the maximum number of loading cycles, stiffness, the permanent plastic deformation of the specimens during the cyclic fatigue tests, and the maximum displacement range in the hysteresis loops of the cyclic loading responses. Results: In each test, all bone-implant constructs with the size 2 Activmotion plate failed with a fracture of the lateral cortex, like with the other five previously tested implants. For the static compression tests the failure occurred in each tested implant above the physiological loading of slow walking (> 2400 N). The load at failure for the Activmotion group was the highest (8200 N). In terms of maximum load and number of cycles performed prior to failure, the size 2 Activmotion plate showed higher results than all the other tested implants except the ContourLock plate. The iBalance implant offered the highest stiffness (3.1 kN/mm) for static loading on the lateral side, while the size 2 Activmotion showed the highest stiffness (4.8 kN/mm) in cyclic loading. Conclusions: Overall, regarding all of the analysed strength parameters, the size 2 Activmotion plate provided equivalent or higher mechanical stability compared to the previously tested implant. Implants with a metaphyseal slope adapted to the tibia anatomy, and positioned more anteriorly on the proximal medial side of the tibia, should provide good mechanical stability.

    Original languageEnglish
    Article number39
    JournalJournal of Experimental Orthopaedics
    Issue number1
    Publication statusPublished - 1 Dec 2017


    • Activmotion- TomoFix
    • Biomechanics
    • ContourLock
    • Correction angle
    • Fatigue strength
    • High tibial osteotomy (HTO)
    • Mechanical stiffness
    • Osteoarthritis
    • PEEKPower
    • Permanent deformation
    • Static strength
    • iBalance


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