Publications by authors named "Cari R Bryant"

3 Publications

  • Page 1 of 1

The stability of three commercially available implants used in medial opening wedge high tibial osteotomy.

J Knee Surg 2006 Apr;19(2):95-8

Division of Sports Medicine, Department of Orthopedic Surgery, University of Michigan, Ann Arbor, USA.

This biomechanical study tested three commercially available fixation devices for medial opening wedge high tibial osteotomy (HTO). A medial opening wedge HTO model was created on replicate tibias. Fixation was achieved with one of three fixation devices: VS Osteotomy plate (EBI, Parsippany, NJ), Arthrex Osteotomy plate (Arthrex, Naples, Fla), and OsteoTrac plate (DJ Orthopedics Inc, Vista, Calif). For each fixation system, seven specimens were cyclically loaded in compression and torsion under physiologic loads on a servohydraulic machine. Mean axial stiffness was 2425 N/mm, 2358 N/mm and 2258 N/mm, respectively, for the EBI, Arthrex, and Alaron surgical plates. Mean torsional stiffness was 4.5 Nm/degree, 4.1 Nm/degree and 4.0 Nm/degree, respectively, for the EBI, Arthrex, and DJ Orthopedics surgical plates. Though the differences are not statistically significant between the three fixation devices (P=.74 for mean axial stiffness and P=.10 for mean torsional stiffness), there is insufficient statistical power to rule out a true difference. Using this replicate tibia model, all three fixation devices tested appear to successfully stabilize the osteotomy site with regards to physiologic axial and torsional loads.
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http://dx.doi.org/10.1055/s-0030-1248086DOI Listing
April 2006

The effect of lateral cortex disruption and repair on the stability of the medial opening wedge high tibial osteotomy.

Am J Sports Med 2005 Oct 11;33(10):1552-7. Epub 2005 Jul 11.

Division of Sports Medicine, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48106, USA.

Background: Medial opening wedge high tibial osteotomy is gaining popularity as a treatment option for medial compartment degenerative disease in the young, active patient. One of the potential technical pitfalls of this procedure is inadvertent disruption of the lateral tibial cortex during distraction at the osteotomy site.

Purpose: (1) To investigate the effect of lateral cortex disruption on stability during medial opening wedge high tibial osteotomy and (2) to evaluate 3 different methods of repair of the disrupted lateral cortex.

Study Design: Controlled laboratory study.

Methods: A total of 50 validated replicate tibias were evaluated in a medial opening wedge high tibial osteotomy model. Specimens were divided into 5 groups: (1) control, or intact lateral cortex (n = 10); (2) disrupted lateral cortex (n = 10); (3) lateral cortex repaired with 1 staple (n = 10); (4) lateral cortex repaired with 2 staples (n = 10); and (5) lateral cortex repaired with a periarticular plate and screws (n = 10). Specimens were placed in compression and torsion under physiologic loads, and stiffness and micromotion were calculated.

Results: Disruption of the lateral cortex resulted in a 58% reduction in axial stiffness and a 68% reduction in torsional stiffness compared to control specimens (P < .05). Disruption of the lateral cortex also resulted in increased micromotion at the osteotomy site. All 3 methods of repair of the lateral cortex restored stiffness and micromotion values to those of the control group (P < .05).

Conclusions: Instability at the osteotomy site may contribute to the high rate of delayed union or nonunion associated with medial opening wedge high tibial osteotomy. Repair of the lateral tibial cortex by each of these techniques restored stability to the osteotomy site in this replicate tibia model and might be effective in clinical use. However, more studies are needed to further explore the relationship between lateral cortex disruption and patient outcomes in the clinical setting before definitive conclusions can be drawn.
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http://dx.doi.org/10.1177/0363546505275488DOI Listing
October 2005

Glenoid inclination is associated with full-thickness rotator cuff tears.

Clin Orthop Relat Res 2003 Feb(407):86-91

Orthopaedic Research Laboratories and University of Michigan Shoulder Group, University of Michigan, Ann Arbor, MI, USA.

Anatomic factors, such as a hooked acromion, have been associated with rotator cuff disorders. Orientation of the glenoid relative to the scapula has been implicated in shoulder instability, but it has not been linked to rotator cuff disorders. The purpose of the current study was to test the hypothesis that superior inclination of the glenoid is associated with full-thickness rotator cuff tears. Glenoid inclination angles were measured from 16 shoulder radiographs of a convenience sample of eight cadavers in which one shoulder had an intact rotator cuff and the other shoulder had a full-thickness rotator cuff tear. Glenoid inclination angles for shoulders with rotator cuff tears were compared with contralateral normal shoulders using nonparametric statistical analysis. The glenoid inclination angle was greater in cadaver shoulders having full-thickness rotator cuff tears (98.6 degrees ) than in shoulders without tears (91.0 degrees ). A second experiment was done to assess the reliability of using 34 Grashey view radiographs from a clinical population to measure glenoid inclination angle. A method to measure the glenoid inclination on Grashey views was tested and was found to correlate with the inclination angles measured on cadaveric scapulae. Intrarater reliability of measurements from clinical Grashey views was 0.93, and interrater reliability was at least 0.88.
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http://dx.doi.org/10.1097/00003086-200302000-00016DOI Listing
February 2003
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