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Article: Systematic investigation of metallosis associated with magnetically controlled growing rod implantation for early-onset scoliosis

TitleSystematic investigation of metallosis associated with magnetically controlled growing rod implantation for early-onset scoliosis
Authors
KeywordsEarly onset scoliosis
Magnetically controlled growing rod
Metallosis
Spectrum analyses
Histological analyses
Issue Date2020
PublisherBritish Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/
Citation
The Bone & Joint Journal, 2020, v. 102-B n. 10, p. 1375-1383 How to Cite?
AbstractAims: To investigate metallosis in patients with magnetically controlled growing rods (MCGRs) and characterize the metal particle profile of the tissues surrounding the rod. Methods: This was a prospective observational study of patients with early onset scoliosis (EOS) treated with MCGRs and undergoing rod exchange who were consecutively recruited between February 2019 and January 2020. Ten patients were recruited (mean age 12 years (SD 1.3); 2 M:8 F). The configurations of the MCGR were studied to reveal the distraction mechanisms, with crucial rod parts being the distractable piston rod and the magnetically driven rotor inside the barrel of the MCGR. Metal-on-metal contact in the form of ring-like wear marks on the piston was found on the distracted portion of the piston immediately outside the barrel opening (BO) through which the piston rod distracts. Biopsies of paraspinal muscles and control tissue samples were taken over and away from the wear marks, respectively. Spectral analyses of the rod alloy and biopsies were performed to reveal the metal constituents and concentrations. Histological analyses of the biopsies were performed with haematoxylin and eosin staining. Results: Titanium (Ti), vanadium (V), and neodymium (Nd) concentrations in the biopsies taken near the wear marks were found to be significantly higher than those in the control tissue samples. Significantly increased Nd concentrations were also found in the tissues near the barrel of the MCGR. Chronic inflammation was revealed by the histological studies with fibrosis and macrophage infiltration. Black particles were present within the macrophages in the fibrotic tissues. Conclusion: Ti and V were generated mainly at the BO due to metal-on-metal contact, whereas the Nd from the rotor of the MCGR is likely released from the BO during distraction sessions. Phagocytotic immune cells with black particles inside raise concern regarding the long-term implications of metallosis.
Persistent Identifierhttp://hdl.handle.net/10722/295329
ISSN
2021 Impact Factor: 5.385
2020 SCImago Journal Rankings: 2.587
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZhang, T-
dc.contributor.authorSze, KY-
dc.contributor.authorPeng, ZW-
dc.contributor.authorCheung, KMC-
dc.contributor.authorLui, YF-
dc.contributor.authorWong, YW-
dc.contributor.authorKwan, KYH-
dc.contributor.authorCheung, JPY-
dc.date.accessioned2021-01-11T13:58:34Z-
dc.date.available2021-01-11T13:58:34Z-
dc.date.issued2020-
dc.identifier.citationThe Bone & Joint Journal, 2020, v. 102-B n. 10, p. 1375-1383-
dc.identifier.issn2049-4394-
dc.identifier.urihttp://hdl.handle.net/10722/295329-
dc.description.abstractAims: To investigate metallosis in patients with magnetically controlled growing rods (MCGRs) and characterize the metal particle profile of the tissues surrounding the rod. Methods: This was a prospective observational study of patients with early onset scoliosis (EOS) treated with MCGRs and undergoing rod exchange who were consecutively recruited between February 2019 and January 2020. Ten patients were recruited (mean age 12 years (SD 1.3); 2 M:8 F). The configurations of the MCGR were studied to reveal the distraction mechanisms, with crucial rod parts being the distractable piston rod and the magnetically driven rotor inside the barrel of the MCGR. Metal-on-metal contact in the form of ring-like wear marks on the piston was found on the distracted portion of the piston immediately outside the barrel opening (BO) through which the piston rod distracts. Biopsies of paraspinal muscles and control tissue samples were taken over and away from the wear marks, respectively. Spectral analyses of the rod alloy and biopsies were performed to reveal the metal constituents and concentrations. Histological analyses of the biopsies were performed with haematoxylin and eosin staining. Results: Titanium (Ti), vanadium (V), and neodymium (Nd) concentrations in the biopsies taken near the wear marks were found to be significantly higher than those in the control tissue samples. Significantly increased Nd concentrations were also found in the tissues near the barrel of the MCGR. Chronic inflammation was revealed by the histological studies with fibrosis and macrophage infiltration. Black particles were present within the macrophages in the fibrotic tissues. Conclusion: Ti and V were generated mainly at the BO due to metal-on-metal contact, whereas the Nd from the rotor of the MCGR is likely released from the BO during distraction sessions. Phagocytotic immune cells with black particles inside raise concern regarding the long-term implications of metallosis.-
dc.languageeng-
dc.publisherBritish Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/-
dc.relation.ispartofThe Bone & Joint Journal-
dc.subjectEarly onset scoliosis-
dc.subjectMagnetically controlled growing rod-
dc.subjectMetallosis-
dc.subjectSpectrum analyses-
dc.subjectHistological analyses-
dc.titleSystematic investigation of metallosis associated with magnetically controlled growing rod implantation for early-onset scoliosis-
dc.typeArticle-
dc.identifier.emailZhang, T: tgzhang@hku.hk-
dc.identifier.emailSze, KY: kysze@hku.hk-
dc.identifier.emailPeng, ZW: pengzw@hku.hk-
dc.identifier.emailCheung, KMC: cheungmc@hku.hk-
dc.identifier.emailWong, YW: yatwa@hkucc.hku.hk-
dc.identifier.emailKwan, KYH: kyhkwan@hku.hk-
dc.identifier.emailCheung, JPY: cheungjp@hku.hk-
dc.identifier.authorityZhang, T=rp02821-
dc.identifier.authoritySze, KY=rp00171-
dc.identifier.authorityCheung, KMC=rp00387-
dc.identifier.authorityKwan, KYH=rp02014-
dc.identifier.authorityCheung, JPY=rp01685-
dc.description.naturepostprint-
dc.identifier.doi10.1302/0301-620X.102B10.BJJ-2020-0842.R1-
dc.identifier.pmid32993330-
dc.identifier.scopuseid_2-s2.0-85089511251-
dc.identifier.hkuros320892-
dc.identifier.volume102-B-
dc.identifier.issue10-
dc.identifier.spage1375-
dc.identifier.epage1383-
dc.identifier.isiWOS:000586599000019-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl2049-4394-

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