Metallosis following implantation of magnetically controlled growing rods in the treatment of scoliosis: a case series

Bone Joint J. 2016 Dec;98-B(12):1662-1667. doi: 10.1302/0301-620X.98B12.38061.

Abstract

Aims: We present a case series of five patients who had revision surgery following magnetic controlled growing rods (MGCR) for early onset scoliosis. Metallosis was found during revision in four out of five patients and we postulated a mechanism for rod failure based on retrieval analysis.

Patients and methods: Retrieval analysis was performed on the seven explanted rods. The mean duration of MCGR from implantation to revision was 35 months (17 to 46). The mean age at revision was 12 years (7 to 15; four boys, one girl).

Results: A total of six out of seven rods had tissue metallosis and pseudo-capsule surrounding the actuator. A total of four out of seven rods were pistoning. There were two rods which were broken. All rods had abrasive circumferential markings. A significant amount of metal debris was found when the actuators were carefully cut open. Analytical electron microscopy demonstrated metal fragments of predominantly titanium with a mean particle size of 3.36 microns (1.31 to 6.61).

Conclusion: This study highlights concerns with tissue metallosis in MCGR. We recommend careful follow-up of patients who have received this implant. Cite this article: Bone Joint J 2016;98-B:1662-7.

Keywords: Early onset scoliosis; Magnetic controlled growing rods; Metallosis.

Publication types

  • Case Reports

MeSH terms

  • Bone Nails / adverse effects*
  • Child
  • Child, Preschool
  • Device Removal
  • Female
  • Follow-Up Studies
  • Foreign Bodies / etiology*
  • Foreign Bodies / metabolism
  • Foreign Bodies / pathology
  • Humans
  • Magnetics
  • Male
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation / methods
  • Scoliosis / surgery*
  • Titanium / analysis

Substances

  • Titanium