Tibial Plateau Leveling Osteotomy Plate Design Influences Interfragmentary Compression: An In Vitro Study.

Abstract

To compare immediate, static interfragmentary compression patterns of three tibial plateau leveling osteotomy (TPLO) plate designs.TPLO was performed on 15 synthetic canine tibiae (SYNBONE AG, Switzerland) using 3D-printed guides. Compression was evaluated using pressure-sensitive films (Prescale, Fujifilm, UK). Three 3.5-mm TPLO plates were tested according to the manufacturer guidelines for dynamic compression screws placement: Synthes, Arthrex, and Biocurve. Each plate was tested five times using a new bone model. The interfragmentary surface was divided into quadrants: Q1 (craniomedial), Q2 (craniolateral), Q3 (caudomedial), and Q4 (caudolateral). Compression was classified as low (<0.12 MPa), moderate (0.12-0.25 MPa), or high (>0.25 MPa).Significant differences in overall interfragmentary compression were found among the plates (p < 0.001). The Biocurve plate generated the highest and most uniform compression (Q1: 0.285 ± 0.023 MPa; Q2: 0.304 ± 0.010 MPa; Q3: 0.220 ± 0.014 MPa; Q4: 0.237 ± 0.010 MPa). The Arthrex plate produced high compression in Q2 (0.292 ± 0.012 MPa) and moderate in other quadrants (Q1: 0.177 ± 0.016 MPa; Q3: 0.141 ± 0.011 MPa; Q4: 0.189 ± 0.013 MPa). The Synthes plate showed the lowest compression throughout (Q1: 0.050 ± 0.008 MPa; Q2: 0.075 ± 0.009 MPa; Q3: 0.111 ± 0.008 MPa; Q4: 0.109 ± 0.008 MPa).The Biocurve plate, with two angled dynamic compression screw holes, provided the highest, most uniform compression. Further studies are needed to assess clinical relevance.