Fixation stability and stress redistribution following metal block use in opening-wedge high tibial osteotomy: a finite element analysis

Metal block augmentation improved the biomechanical stability in OWHTO constructs, with greater grains in uniplanar osteotomies and LHF models. This enhancement was accompanied by altered stress distribution, characterized by increased stress on the plate and reduced stress in the proximal tibia, suggesting a potential stress-shielding effect. By quantifying these effects under various conditions, this study provides biomechanical evidence for the selective application of metal block augmentation in clinical practice.