The STRYDE limb lengthening nail is susceptible to mechanically assisted crevice corrosion: an analysis of 23 retrieved implants

Authors

  • Jan Duedal Rölfing Orthopaedic Reconstruction and Children’s Orthopaedics, Aarhus University Hospital, Aarhus, Denmark
  • Morten Stendahl Jellesen Department of Mechanical Engineering, Technical University of Denmark, Lyngby; 2 Materials and Product Testing, FORCE Technology, Brøndby
  • Trine Nybo Lomholt Materials and Product Testing, FORCE Technology, Brøndby
  • Rikke Quist Hansen Department of Mechanical Engineering, Technical University of Denmark, Lyngby; Materials and Product Testing, FORCE Technology, Brøndby
  • Troels Mathiesen Materials and Product Testing, FORCE Technology, Brøndby
  • Carsten Gundlach Department of Physics, Technical University of Denmark, Lyngby
  • Søren Kold Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg
  • Tobias Nygaard Department of Orthopaedics, Limb Lengthening and Bone Reconstruction Unit, Rigshospitalet, Copenhagen
  • Mindaugas Mikuzis Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg
  • Ulrik Kähler Olesen Department of Orthopaedics, Limb Lengthening and Bone Reconstruction Unit, Rigshospitalet, Copenhagen

DOI:

https://doi.org/10.1080/17453674.2021.1927506

Abstract

Background and purpose — We noted several adverse events in patients in whom the first version of the STRYDE limb-lengthening nail (NuVasive Specialized Orthopaedics, San Diego, CA) had been implanted. Pain, osteolysis, peri- osteal reactions, and cortical hypertrophy at the nail junc- tion were noted. Here, we present the analysis of 23 retrieved STRYDE implants.

Materials and methods — We undertook visual inspec- tion of the retrieved nails and screws, mechanical evaluation of the junction, micro-CT analyses, microscopic inspection of the bushing, screws, screw holes, and separated parts of the implants. Positive material identification (PMI) and energy-dispersive X-ray spectroscopy (EDS) were used to analyze the chemical composition. The hardness of the mate- rial was also investigated.

Results — 20/23 retrieved nails had visible signs of cor- rosion, i.e., discoloration at the telescopic junction. Micro- CT verified corrosion attacks in 12/12 scanned bushings. Corrosion, predominantly mechanically assisted crevice corrosion, was observed at the locking screws and screw holes in 20/23 nails. Biological material inside the nail was observed in addition to oozing from the junction of 2 nails during hardware removal, which was experimentally repro- ducible. Notably, the mechanical construction of the bushing changed from PRECICE P2 to STRYDE nails.

Interpretation — STRYDE nails are not hermetically sealed, and liquid can pass the bushing. Biodur 108 itself is corrosion resistant; however, mechanically assisted crev- ice corrosion of the bushing, locking screws, and screw holes may be aggravated due to manufacturing aiming for increased strength and hardness of the alloy.

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Published

2021-06-08

How to Cite

Rölfing, J. D., Jellesen, M. S. ., Lomholt, T. N., Hansen, R. Q., Mathiesen, T., Gundlach, C., … Olesen , U. K. (2021). The STRYDE limb lengthening nail is susceptible to mechanically assisted crevice corrosion: an analysis of 23 retrieved implants. Acta Orthopaedica, 92(5), 621–627. https://doi.org/10.1080/17453674.2021.1927506