Modes of Failure of Custom Expandable Repiphysis Prostheses by Aditya V. Maheshwari, Patrick F. Bergin, and Robert M. Henshaw J Bone Joint Surg Am Volume.

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Presentation transcript:

Modes of Failure of Custom Expandable Repiphysis Prostheses by Aditya V. Maheshwari, Patrick F. Bergin, and Robert M. Henshaw J Bone Joint Surg Am Volume 93(13):e72 July 6, 2011 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A, 2-B, and 2-C Case 2. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior and lateral radiographs, made just before the revision to a new Repiphysis implant, show the fracture of the spring and the expansion mechanism leading to collapse of the previously expanded implant (bold arrows) along with extensive metal w... Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Clinical photograph, made during the revision surgery, shows extensive metallosis with a dark greenish-gray pseudocapsule surrounding the prosthesis. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A through 3-E Case 3. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior radiographs made immediately after the first surgery (left) and at the time of the three-month follow-up (right) show substantial lengthening of the implant with expansion of the spring mechanism and failure of the trumpet flare (arrows). Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Intraoperative photograph shows the broken spring mechanism. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Photograph showing the extracted parts of the spring mechanism and the trumpet flare (arrow). Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior and lateral radiographs made after injection of the bone cement through the window in the prosthesis to lock the expansion mechanism in situ and to seal the internal mechanism. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.

An illustration showing the internal design of a Repiphysis distal femoral replacement prosthesis. Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72 ©2011 by The Journal of Bone and Joint Surgery, Inc.