Análise biomecanica de placa modificada de tplo em modelo experimental de falha óssea proximal em tíbias sintéticas caninas
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Data
2017-05-30
Autores
Sembenelli, Guilherme [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do presente estudo foi desenvolver placa de TPLO bloqueada modificada e avaliar a eficácia da estabilização óssea proporcionada pelo implante desenvolvido comparativamente a outros dois métodos convencionais de fixação óssea (placa bloqueada e placa bloqueada associada a pino intramedular). Por meio de estudos biomecânicos, avaliaram-se as construções às forças de torção, flexão craniocaudal, flexão mediolateral e compressão axial. Foram utilizadas sessenta tíbias sintéticas dividas em três grupos. O Grupo 1 (placa TPLO modificada), o Grupo 2 (placa bloqueada) e o Grupo 3 (placa bloqueada associada a pino intramedular) foram qsubdivididos em quatro grupos de cinco tíbias. Os ensaios foram realizados até a falha da montagem (implantes e/ou tíbia) e os resultados obtidos comparados entre os grupos. As variáveis estudadas foram analisadas sob delineamento inteiramente casualizado no esquema fatorial 3 por 4 com 5 repetições para cada combinação do esquema fatorial. Os resultados foram submetidos à análise de variância e as médias comparadas entre si pelo teste de Tukey a 5% de probabilidade. No ensaio de compressão axial houve diferença significativa em relação a variável força máxima em que o Grupo 3 obteve maior média, não havendo diferença significativa entre os Grupos 1 e 2. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de flexão em três pontos craniocaudal houve diferença significativa em relação às três variáveis estudas. Na variável força máxima G2>G3=G1, na variável deflexão G3>G1=G2 e na variável rigidez G3=G2, G2=G1 G3>G1. Todas as montagens falharam devido à quebra do corpo de prova. No ensaio de flexão mediolateral houve diferença significativa em relação a variável rigidez em que G3>G2=G1. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de torção houve diferença significativa em relação às variáveis ângulo no pico de torque e rigidez. Na variável ângulo no pico de torque G2>G1=G3. Na variável rigidez G1=G3>G2. Todas as montagens falharam devido à quebra do corpo de prova distal a placa. Conclui-se a placa de TPLO modificada apresentou semelhança biomecânica com a placa reta convencional na maioria das variáveis estudadas. O grupo, da associação placa e pino, obtive maiores índices de rigidez comparativamente aos outros dois grupos, exceto no teste de torção em que o grupo da placa de TPLO modificada apresentou o mesmo índice de rigidez que o da associação placa e pino.
The aim of this study was to develop modified TPLO locked plate and to evaluate the effectiveness of stabilization provided by the implant developed compared to two other conventional methods of stabilization (locked plate and plate-rod). Through biomechanical studies the constructions were evaluated to craniocaudal and mediolateral bending, axial compression and torsional forces. Sixty synthetic tibias were used divided into three groups. Group 1 (modified TPLO plate), Group 2 (locked plate) and Group 3 (plate-rod) were subdivided into four groups of five tibiae. The tests were perfomed until failure of the construction (implants / tibia) and the results compared between the groups. The variables studied were analyzed under a completely randomized design in the factorial scheme 3 by 4 with 5 replicates for each combination of the factorial scheme. The results were submitted to analysis of variance and the means compared to each other by the Tukey test at 5% probability. In the axial compression test there was a significant difference in relation to the variable maximum force in which Group 3 obtained higher mean, not having significant difference between Groups 1 and 2. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the mediolateral flexion test there was a significant difference in relation to the stiffness variable in which G3> G2 = G1. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the torsion test there was a significant difference in relation to the variables angle at peak torque and stiffness. In the variable angle at the torque peak G2> G1 = G3. In the stiffness variable G1 = G3> G2. All constructs failed due to the breaking of the synthetic tibia distally to the plate. It is concluded that the modified TPLO plate presented biomechanical similarity with the conventional plate in most of the studied variables. The groups of locking plate an plate-rod constructions obtained higher stiffness indices compared to the other two groups, except for the torsion test in which the modified TPLO plate group had the same stiffness index as the plate and plate-rod.
The aim of this study was to develop modified TPLO locked plate and to evaluate the effectiveness of stabilization provided by the implant developed compared to two other conventional methods of stabilization (locked plate and plate-rod). Through biomechanical studies the constructions were evaluated to craniocaudal and mediolateral bending, axial compression and torsional forces. Sixty synthetic tibias were used divided into three groups. Group 1 (modified TPLO plate), Group 2 (locked plate) and Group 3 (plate-rod) were subdivided into four groups of five tibiae. The tests were perfomed until failure of the construction (implants / tibia) and the results compared between the groups. The variables studied were analyzed under a completely randomized design in the factorial scheme 3 by 4 with 5 replicates for each combination of the factorial scheme. The results were submitted to analysis of variance and the means compared to each other by the Tukey test at 5% probability. In the axial compression test there was a significant difference in relation to the variable maximum force in which Group 3 obtained higher mean, not having significant difference between Groups 1 and 2. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the mediolateral flexion test there was a significant difference in relation to the stiffness variable in which G3> G2 = G1. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the torsion test there was a significant difference in relation to the variables angle at peak torque and stiffness. In the variable angle at the torque peak G2> G1 = G3. In the stiffness variable G1 = G3> G2. All constructs failed due to the breaking of the synthetic tibia distally to the plate. It is concluded that the modified TPLO plate presented biomechanical similarity with the conventional plate in most of the studied variables. The groups of locking plate an plate-rod constructions obtained higher stiffness indices compared to the other two groups, except for the torsion test in which the modified TPLO plate group had the same stiffness index as the plate and plate-rod.
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Palavras-chave
Biomecânica, Ortopedia, Osteossíntese, Placa, Orthopedics, Osteosynthesis, Biomechanics