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Whitney et al: Ex vivo biomechanical comparison of four Center of Rotation Angulation Based Leveling Osteotomy fixation methods
Veterinary Surgery 1, 2022

🔍 Key Findings

  • CBLO fixation with both a headless compression screw (HCS) and tension band (TB) showed the highest yield and ultimate loads compared to other configurations
  • HCSTB constructs had significantly higher yield load (1212 N) and ultimate load (1388 N) than Plate alone (788 N, 774 N), HCS alone (907 N, 927 N), or TB alone (1016 N, 1076 N)
  • No difference in construct stiffness was detected among the four fixation methods tested
  • All constructs ultimately failed by bone fracture—location of failure differed by construct type (e.g., through HCS hole or cranial screw hole)
  • TB and HCSTB groups showed failure via progressive TB stretching and cranial osteotomy widening, while Plate and HCS failed more abruptly
  • All constructs withstood forces exceeding expected quadriceps load in vivo (170–325 N), suggesting all methods can resist physiological loading, but HCSTB provides greater safety margin
  • HCS alone was not significantly stronger than Plate or TB alone, questioning its standalone superiority
  • Study supports using TB and HCS together for optimal construct strength, but clinical studies are needed to validate implant fatigue, healing, and failure rates

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← Articles

Whitney et al: Ex vivo biomechanical comparison of four Center of Rotation Angulation Based Leveling Osteotomy fixation methods
Veterinary Surgery 1, 2022

🔍 Key Findings

  • CBLO fixation with both a headless compression screw (HCS) and tension band (TB) showed the highest yield and ultimate loads compared to other configurations
  • HCSTB constructs had significantly higher yield load (1212 N) and ultimate load (1388 N) than Plate alone (788 N, 774 N), HCS alone (907 N, 927 N), or TB alone (1016 N, 1076 N)
  • No difference in construct stiffness was detected among the four fixation methods tested
  • All constructs ultimately failed by bone fracture—location of failure differed by construct type (e.g., through HCS hole or cranial screw hole)
  • TB and HCSTB groups showed failure via progressive TB stretching and cranial osteotomy widening, while Plate and HCS failed more abruptly
  • All constructs withstood forces exceeding expected quadriceps load in vivo (170–325 N), suggesting all methods can resist physiological loading, but HCSTB provides greater safety margin
  • HCS alone was not significantly stronger than Plate or TB alone, questioning its standalone superiority
  • Study supports using TB and HCS together for optimal construct strength, but clinical studies are needed to validate implant fatigue, healing, and failure rates

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Multiple Choice Questions on this study

In Whitney 2022 et al., on CBLO fixation strength, which CBLO construct demonstrated significantly **higher yield load** than all other configurations tested?

A. CBLO plate with HCS only
B. CBLO plate with TB only
C. CBLO plate only
D. CBLO plate with HCS and TB
E. CBLO plate with pins and locking screws

Answer: CBLO plate with HCS and TB

Explanation: The HCSTB construct had the highest yield load (1212 N), superior to all other methods.
In Whitney 2022 et al., on CBLO fixation strength, what conclusion can be drawn about the **use of HCS alone** for CBLO fixation based on biomechanical results?

A. It provides the strongest construct
B. It significantly outperforms tension band alone
C. It performs worse than plate alone
D. It performs similarly to TB and Plate alone
E. It eliminates the need for a plate

Answer: It performs similarly to TB and Plate alone

Explanation: HCS alone did not significantly outperform Plate or TB in yield or ultimate load.
In Whitney 2022 et al., on CBLO fixation strength, regarding biomechanical testing of CBLO constructs, what was the main mode of failure in constructs using only a plate and pin?

A. Fracture through HCS hole
B. Stretching of tension band
C. Displacement of tibial tuberosity then fracture at cranial screw
D. Failure at patellar tendon
E. Fracture at distal screw site

Answer: Displacement of tibial tuberosity then fracture at cranial screw

Explanation: Plate-only constructs failed by tuberosity displacement followed by fracture at the most cranial screw.
In Whitney 2022 et al., on CBLO fixation strength, which variable was found to have **no significant effect** on construct stiffness, yield load, or ultimate load in CBLO testing?

A. Use of tension band
B. Use of HCS
C. Use of combined HCSTB
D. Body weight of the dog
E. Type of screw (locking vs cortical)

Answer: Body weight of the dog

Explanation: Body weight did not influence any of the biomechanical outcomes measured.
In Whitney 2022 et al., on CBLO fixation strength, which construct showed the highest **ultimate load capacity** during ex vivo testing?

A. CBLO plate with pin only
B. CBLO plate with headless compression screw (HCS)
C. CBLO plate with tension band (TB)
D. CBLO plate with HCS and TB (HCSTB)
E. CBLO plate with locking screws only

Answer: CBLO plate with HCS and TB (HCSTB)

Explanation: HCSTB had the highest ultimate load (1388 N), significantly outperforming other configurations.

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