Fixation strength of anterior tibial tuberosity osteotomy in revision knee arthroplasty according to cerclage wire configuration: An experimental animal model.
basic_science · Level V
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- Record sourced from PubMed, PMID 42296688.
- Also identified by DOI 10.1016/j.knee.2026.104551.
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Abstract
An anterior tibial tuberosity osteotomy (ATTO) is an effective technique to achieve adequate exposure and visualization of the knee joint during revision total knee arthroplasty (TKA). However, various fixation methods have been described once the osteotomy has fulfilled its purpose, with horizontal wire cerclage being one of the most commonly used techniques. The objective of this study was to evaluate biomechanical differences in fixation strength and displacement among four cerclage configurations using a porcine ATTO model. Four different wire cerclage configurations for ATTO fixation were evaluated: (1) horizontal, (2) inferior oblique, (3) superior oblique, and (4) mixed oblique. A total of 40 complete porcine knee joints were used in this study, with 10 specimens randomly assigned to each group. The evaluated outcomes were maximum displacement and maximum load to failure. The inferior oblique cerclage demonstrated the highest resistance to maximum load, with a median of 950.7 N (interquartile range (IQR): 873.0 to 974.1), significantly outperforming the superior and horizontal cerclage configurations (P < 0.05). The greatest displacement was observed in the horizontal cerclage group, with a median of 20.2 mm (IQR: 18.1 to 23.5), whereas the inferior and superior configurations showed the lowest displacement values. Based on the porcine ATTO model, the inferior oblique wire cerclage provided the greatest resistance to maximum load and the lowest displacement, outperforming even the horizontal configuration.