modes of failure of custom expandable repiphysis prostheses by aditya v. maheshwari, patrick f....
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![Page 1: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/1.jpg)
Modes of Failure of Custom Expandable Repiphysis Prostheses
by Aditya V. Maheshwari, Patrick F. Bergin, and Robert M. Henshaw
J Bone Joint Surg AmVolume 93(13):e72
July 6, 2011
©2011 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/2.jpg)
Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72
©2011 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/3.jpg)
Aditya V. Maheshwari et al. J Bone Joint Surg Am 2011;93:e72
©2011 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/4.jpg)
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.
![Page 5: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/5.jpg)
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.
![Page 6: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/6.jpg)
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.
![Page 7: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/7.jpg)
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.
![Page 8: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/8.jpg)
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.
![Page 9: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/9.jpg)
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.
![Page 10: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/10.jpg)
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.
![Page 11: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/11.jpg)
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.
![Page 12: 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](https://reader036.vdocuments.mx/reader036/viewer/2022070415/56649ee65503460f94bf6648/html5/thumbnails/12.jpg)
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.