Biomechanical analysis of titanium alloy porous spacer-enhanced high tibial osteotomy versus conventional T-shaped plate and bone grafting

• Titanium alloy porous block-enhanced high tibial osteotomy (Model C) significantly reduced maximum displacement under both standing and rising conditions compared to conventional T-shaped plate (Model A) and bone grafting (Model B). • Model C exhibited the lowest T-shaped plate stress levels, with reductions of 91.2% (standing) and 92.9% (rising) compared to Model A, indicating superior stress distribution. • The porous block design lowered stress at the lateral hinge site, potentially reducing the risk of lateral hinge fractures. • Finite element analysis suggests that titanium alloy porous blocks improve initial stability and promote bone healing, offering a promising alternative to traditional fixation methods.