Mechanical Analysis of Explanted Telescopic Rods in the Management of Osteogenesis Imperfecta: A Multicenter Study

NICOLAOU, Nicolas, LUO, Quanshun, GILES, Stephen N., MARUTHAINAR, Kunalan, KITCHEN, Matthew P., THOMAS, Simon, FERNANDES, James A. and ROPOSCH, Andreas (2021). Mechanical Analysis of Explanted Telescopic Rods in the Management of Osteogenesis Imperfecta: A Multicenter Study. Journal of Pediatric Orthopaedics, 41 (6), e448-e456.

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Official URL: http://dx.doi.org/10.1097/BPO.0000000000001796
Link to published version:: https://doi.org/10.1097/BPO.0000000000001796
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    Abstract

    Background: Telescopic rods in the management of osteogenesis imperfecta fail frequently. This could be attributed to technical errors, rod design, and rod structure. We aimed to analyze the mechanical properties and tribology of explanted male and female components to identify effects of in vivo telescoping that may relate to observed patterns of successful telescoping or failure. Methods: Recruitment took place at 3 of the 4 English centers for osteogenesis imperfecta. Twenty-five rods explanted for growth or failure during revision to a new rod were analyzed in terms of clinical indication and prerevision imaging to identify if there was a technical mode of failure. Laboratory analysis was performed using optical and scanning electrical microscopy, radiograph diffraction analysis, hardness test, bending test, and energy-dispersive x-ray spectroscopy. Results: All implants tested were of high-grade stainless steel. Female components had inferior strength [mean Vickers hardness property (HV0.3) at 0.3 to 313 kg] in comparison to male components (HV0.3 406) due to different techniques of manufacture. Female rods also had a higher wear coefficient (7.89×10−12 m3/N/m3) than the male rods (6.46×10−12 m3/N/m3). Abrasive wear, shear deformation, scratches, and wear debris were identified in all rods. Male and female components displayed corrosion contributing to adhesive wear. Intraoperatively cut rods, particularly the female components, had irregular ends leading to more wear. Conclusions: Current manufacturing techniques result in inferior material strength in female components compared with males, which combined with wear patterns is likely to lead to implant failure. Intraoperative cutting of rods may increase risk of failure due to wear. Considering techniques to improve strength as well as design in new implants may lead to better outcomes.

    Item Type: Article
    Additional Information: This is a non-final version of an article published in final form in Journal of Pediatric Orthopaedics: July 2021 - Volume 41 - Issue 6 - p e448-e456
    Identification Number: https://doi.org/10.1097/BPO.0000000000001796
    Page Range: e448-e456
    Depositing User: Colin Knott
    Date Deposited: 19 Aug 2021 14:36
    Last Modified: 20 Aug 2021 16:40
    URI: http://shura.shu.ac.uk/id/eprint/28962

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