Cureus · 2026
Pore Orientation Affects the Compression Resistance of Unidirectional Porous Beta-Tricalcium Phosphate Wedges in Opening-Wedge High Tibial Osteotomy.
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Kawahara Shinya, Shimoto Takeshi, Hamai Satoshi, Akasaki Yukio, Sato Taishi, Nakashima Yasuharu
Аннотация
BACKGROUND: Unidirectional porous beta-tricalcium phosphate is used as a synthetic bone substitute in opening-wedge high tibial osteotomy. Because this material has anisotropic mechanical properties, the orientation of its interconnected pores may influence initial support within the osteotomy gap. This study evaluated whether pore orientation affects the compression resistance of unidirectional porous beta-tricalcium phosphate wedges in an opening-wedge high tibial osteotomy-like loading model.
MATERIALS AND METHODS: This in vitro biomechanical study evaluated two wedge sizes: WA08, corresponding to an approximately 7.6-degree wedge, and WA14, corresponding to an approximately 14.3-degree wedge. For each size, three configurations were tested: the commercially preformed wedge with pores parallel to the medial and lateral faces, a processed block with pores perpendicular to the lower surface, and a processed block with pores perpendicular to the upper surface. Ten specimens were tested per configuration. Monotonic compression was applied using a hinged fixture that reproduced the geometry of an opening-wedge high tibial osteotomy gap. Load-displacement and nominal contact pressure-displacement curves were compared by pairwise comparisons at each 0.01 mm displacement increment.
RESULTS: In WA08, the commercially preformed configuration showed greater resistance at larger displacements, with significant differences from the lower-surface and upper-surface perpendicular configurations beginning at 0.37 and 0.41 mm, respectively. In WA14, the commercially preformed and upper-surface perpendicular configurations showed higher load-displacement and nominal pressure-displacement responses than the lower-surface perpendicular configuration.
CONCLUSIONS: Pore orientation affected the initial compression behavior of unidirectional porous beta-tricalcium phosphate wedges in a simulated opening-wedge high tibial osteotomy gap. The commercially preformed configuration showed the most consistent resistance across wedge sizes, suggesting that pore orientation should be considered when selecting or shaping beta-tricalcium phosphate wedges for opening-wedge high tibial osteotomy.
MATERIALS AND METHODS: This in vitro biomechanical study evaluated two wedge sizes: WA08, corresponding to an approximately 7.6-degree wedge, and WA14, corresponding to an approximately 14.3-degree wedge. For each size, three configurations were tested: the commercially preformed wedge with pores parallel to the medial and lateral faces, a processed block with pores perpendicular to the lower surface, and a processed block with pores perpendicular to the upper surface. Ten specimens were tested per configuration. Monotonic compression was applied using a hinged fixture that reproduced the geometry of an opening-wedge high tibial osteotomy gap. Load-displacement and nominal contact pressure-displacement curves were compared by pairwise comparisons at each 0.01 mm displacement increment.
RESULTS: In WA08, the commercially preformed configuration showed greater resistance at larger displacements, with significant differences from the lower-surface and upper-surface perpendicular configurations beginning at 0.37 and 0.41 mm, respectively. In WA14, the commercially preformed and upper-surface perpendicular configurations showed higher load-displacement and nominal pressure-displacement responses than the lower-surface perpendicular configuration.
CONCLUSIONS: Pore orientation affected the initial compression behavior of unidirectional porous beta-tricalcium phosphate wedges in a simulated opening-wedge high tibial osteotomy gap. The commercially preformed configuration showed the most consistent resistance across wedge sizes, suggesting that pore orientation should be considered when selecting or shaping beta-tricalcium phosphate wedges for opening-wedge high tibial osteotomy.