In Vitro Assessment of Compression Patterns Using Different Methods to Achieve Interfragmentary Compression during...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Veterinary surgery

Background:

• Tibial plateau levelling osteotomy (TPLO) is a common procedure in veterinary orthopedics.
• Achieving adequate interfragmentary compression is crucial for optimal bone healing after TPLO.
• Various techniques exist to achieve compression, but their comparative effectiveness is not fully elucidated.

Purpose of the Study:

• To evaluate and characterize the effectiveness of different compression methods during TPLO.
• To compare the distribution and magnitude of interfragmentary compression achieved by seven distinct techniques.

Main Methods:

• TPLO was simulated on 20 canine tibia models using 3D-printed guides.
• Seven compression methods, including forceps (K, F) and dynamic compression hole (P), were tested individually and in combination.
• Pressure-sensitive films assessed interfragmentary compression, analyzed across four quadrants.

Main Results:

• Significant differences in mean pressures per quadrant were observed among the methods (p < 0.001).
• Method F+P demonstrated the most even distribution of high interfragmentary compression forces.
• Method K alone resulted in a loss of caudal compression, while its addition to F+P marginally increased cranial compression but reduced caudal compression.

Conclusions:

• The combination of pointed bone reduction forceps (F) and the dynamic compression hole (P) provides superior and more even interfragmentary compression.
• If Kern bone holding forceps (K) are employed, their use in conjunction with F+P is advised to optimize compression distribution.