Analysis of Explanted Magnetically Controlled Growing Rods From Seven UK Spinal Centers

Joyce, Thomas J.; Smith, Simon; Rushton, Paul R. P.; Bowey, Andrew; Gibson, Michael J.

doi:10.1097/brs.0000000000002221

Cited by 66 publications

(60 citation statements)

References 30 publications

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“…Moreover, titanium wear from joint replacements has been shown to induce aneuploidy in vitro and in vivo. The potential links of titanium wear debris to metallosis in children fitted with spinal implants have recently been described …”

Section: Discussionmentioning

confidence: 99%

Wear at the taper‐trunnion junction of contemporary ceramic‐on‐ceramic hips shown in a multistation hip simulator

Bhalekar¹,

Smith²,

Joyce³

2018

J Biomed Mater Res

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Ceramic-on-ceramic (CoC) total hip replacements (THR) have a substantially lower wear rate than metal-on-polyethylene (MoP) hips, as shown by hip simulator testing. However, the revision rates of CoC and MoP hips are comparable. To try and explain this discrepancy the wear, at both the bearing surfaces and taper-trunnion interface of 36 mm BIOLOXdelta CoC THRs, mounted on 12/14 titanium (Ti6Al4V) trunnions was investigated using a hip simulator (n = 3) and a dynamically loaded CoC sample in a separate test station. Wear was assessed gravimetrically and surface roughness measurements of the articulating and taper surfaces taken at regular intervals. Scanning electron microscopy, surface roughness, and gravimetric measurements of trunnions was performed. After 5 million cycles, the mean total wear from the ceramic articulating surfaces was 0.25 mm from the hip simulator test, and that from the titanium trunnions was 0.29 mm . This metal wear may provide an explanation for adverse reaction to metal debris found in contemporary CoC hip joints. It is therefore vital to consider taper-trunnion wear in preclinical testing of artificial hip joints. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2018.

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Section: Discussionmentioning

confidence: 99%

Wear at the taper‐trunnion junction of contemporary ceramic‐on‐ceramic hips shown in a multistation hip simulator

Bhalekar¹,

Smith²,

Joyce³

2018

J Biomed Mater Res

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“…Unfortunately, the magnetically actuated rods only generate 42 pounds of axial force and may fail to generate enough force to elongate after several lengthening procedures. There are also issues related to titanium wear debris noted at the time of device removal [52]. Generally, these devices have made important improvements in the treatment of severe curves seen in young children with PWS.…”

Section: Non-fusion Spinal Instrumentation With Expandable Implantsmentioning

confidence: 99%

Clinical Observations and Treatment Approaches for Scoliosis in Prader–Willi Syndrome

Bosse

Butler

2020

Genes

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Prader–Willi syndrome (PWS) is recognized as the first example of genomic imprinting, generally due to a de novo paternal 15q11-q13 deletion. PWS is considered the most common genetic cause of marked obesity in humans. Scoliosis, kyphosis, and kyphoscoliosis are commonly seen in children and adolescents with PWS with a prevalence of spinal deformities cited between 15% to 86%. Childhood risk is 70% or higher, until skeletal maturity, with a bimodal age distribution with one peak before 4 years of age and the other nearing adolescence. As few reports are available on treating scoliosis in PWS, we described clinical observations, risk factors, therapeutic approaches and opinions regarding orthopedic care based on 20 years of clinical experience. Treatments include diligent radiographic screening, starting once a child can sit independently, ongoing physical therapy, and options for spine casting, bracing and surgery, depending on the size of the curve, and the child’s age. Similarly, there are different surgical choices including a spinal fusion at or near skeletal maturity, versus a construct that allows continued growth while controlling the curve for younger patients. A clear understanding of the risks involved in surgically treating children with PWS is important and will be discussed.

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“…26 Analysis of explanted magnetic expansion control growing rods showed that with the achieved growth during distraction, high volumes of Ti wear debris were formed. 27 These findings emphasize the challenge to address metallosis in EOS surgery.…”

Section: Discussionmentioning

confidence: 93%

The Use of Metal Sublaminar Wires in Modern Growth-Guidance Scoliosis Surgery: A Report of 4 Cases and Literature Review

et al. 2020

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Background: To avoid early fusion and allow residual growth of the spine in early onset scoliosis (EOS) treatment, growth-guided scoliosis surgery can be performed. Four patients with EOS are presented in which a growthguidance instrumentation is used with sliding titanium (Ti) sublaminar cables. Residual growth of the spine can be preserved using metal sublaminar wiring; however, several drawbacks of this technique and type of material are illustrated.Methods: Four patients with progressive neuromuscular scoliosis were treated with a posterior stabilization. A fusionless growth-guidance instrumentation was used consisting of a combination of lumbar pedicle screws and sliding Ti sublaminar cables along cobalt chrome rods.Results: In 2 cases, the described growth-guidance technique provided sufficient stability and correction of the curvature with preservation of growth. In 2 patients, the instrumentation failed due to upper thoracic sublaminar wire breakage. The ongoing abrasion of the rod-wire interface caused severe metallosis. In these cases, a debridement and revision surgery was performed with partial fusion of the spine.Conclusions: Growth-guidance techniques with sliding metal sublaminar wires seem to be a valuable solution for the preservation of spinal growth in EOS surgery. High curvatures, however, have a higher chance of failure and demand for more corrective strength and support of the instrumentation. The use of metal sublaminar wires in a ''sliding'' instrumentation can lead to early breakage and metallosis.Level of Evidence: 4, case series. Clinical Relevance: Surgeons should be aware of possible complications associated with the use of metal laminar wires in spinal fusion and growth-guidance scoliosis surgery. The implementation of materials containing higher fatigue strength and lower friction properties (eg, UHMWPE wires) may avoid these potential complication risks. Complications

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Analysis of Explanted Magnetically Controlled Growing Rods From Seven UK Spinal Centers

Abstract: 4.

Cited by 66 publications

References 30 publications

Wear at the taper‐trunnion junction of contemporary ceramic‐on‐ceramic hips shown in a multistation hip simulator

Wear at the taper‐trunnion junction of contemporary ceramic‐on‐ceramic hips shown in a multistation hip simulator

Clinical Observations and Treatment Approaches for Scoliosis in Prader–Willi Syndrome

The Use of Metal Sublaminar Wires in Modern Growth-Guidance Scoliosis Surgery: A Report of 4 Cases and Literature Review

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