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Author Topic: Very very imp(risk of corrosion related osteolysis)  (Read 459 times)

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Dirona

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Very very imp(risk of corrosion related osteolysis)
« on: April 09, 2022, 07:02:18 AM »

Most people here  are celebrating after finishing lengthening and consolidation. However, because of the debris left by the nails(btw this could happen with Precice as well. With Stryde, the chances are as high as 80 percent), it could result in osteolysis. This will result in bone resorption and will leave hole within the bone or the outer layer of the bone. This is  a progressive thing and can happen long after consolidation is done. The treatment for this is not simple if it happens and would require multiple surgeries. This has already been observed in hip replacement surgeries. It is asymptomatic so you can walk/run after consolidation and think that your life is set. But please remember, this osteolysis   due to metal ions can always occur.  I read a bunch of papers related to it, and also saw Dr Donghoon Lee's video related to the same.  In fact, some say that this is more serious than the other issues like non union etc which can be resolved. Just because you could escape non-union, nerve damage, embolism does not mean osteolysis cannot occur. It can definitely occur.

These guys had warned about corrosion with Precice 2 itself https://backend.orbit.dtu.dk/ws/files/259864408/17453674.2021.pdf
But with stryde, it is more common and hence the recall.

I urge folks to read about osteolysis and then see if they are okay with that risk before doing LL. It is strange that some of the top LL doctors downplay corrosion.this is a cosmetic/elective procedure and hence behooves that the doctor informs the patient about this risk. Just because the patient can walk and this complication can happen much later on does not mean it does not happen. In fact Paley did mention in Victor's video about Stryde that this could occur but the time spent on it was minimal. Victor thought that he was reassuring.

I would not want bone with holes or bone tissue resorption at any cost. I  DO NOT have time for multiple surgeries after this one major surgery. And since we do not have long term data of 30 -40 years with any internal nails like Precice/Stryde, I am worried about the long term complication. Please tell me if I am missing something..
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Dexter5729

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #1 on: April 09, 2022, 07:33:44 AM »

Most people here  are celebrating after finishing lengthening and consolidation. However, because of the debris left by the nails(btw this could happen with Precice as well. With Stryde, the chances are as high as 80 percent), it could result in osteolysis. This will result in bone resorption and will leave hole within the bone or the outer layer of the bone. This is  a progressive thing and can happen long after consolidation is done. The treatment for this is not simple if it happens and would require multiple surgeries. This has already been observed in hip replacement surgeries. It is asymptomatic so you can walk/run after consolidation and think that your life is set. But please remember, this osteolysis   due to metal ions can always occur.  I read a bunch of papers related to it, and also saw Dr Donghoon Lee's video related to the same.  In fact, some say that this is more serious than the other issues like non union etc which can be resolved. Just because you could escape non-union, nerve damage, embolism does not mean osteolysis cannot occur. It can definitely occur.

These guys had warned about corrosion with Precice 2 itself https://backend.orbit.dtu.dk/ws/files/259864408/17453674.2021.pdf
But with stryde, it is more common and hence the recall.

I urge folks to read about osteolysis and then see if they are okay with that risk before doing LL. It is strange that some of the top LL doctors downplay corrosion.this is a cosmetic/elective procedure and hence behooves that the doctor informs the patient about this risk. Just because the patient can walk and this complication can happen much later on does not mean it does not happen. In fact Paley did mention in Victor's video about Stryde that this could occur but the time spent on it was minimal. Victor thought that he was reassuring.

I would not want bone with holes or bone tissue resorption at any cost. I  DO NOT have time for multiple surgeries after this one major surgery. And since we do not have long term data of 30 -40 years with any internal nails like Precice/Stryde, I am worried about the long term complication. Please tell me if I am missing something..
what about LON with different nail than PRECISE and STRYDE?
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Dirona

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #2 on: April 09, 2022, 08:19:41 AM »

No idea about LON
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LLprime3

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #3 on: April 09, 2022, 08:42:48 AM »

The way I see it, stryde (and precise) use different metals/materials at the interface, even if it's "coated", once liquid connects two different metals corrosion occurs. These nails should have been made entirely non-corrosive, instead of relying on a coating to prevent corrosion. I just guess that they have to be constructed like this, reading the reports.

With stryde no one is careful because it's weight bearing and so it wears out a bit, and we see cases of corrosion. Precise should have the same ratio of corrosion if the mechanism and metals at the interface are similar to stryde, but patients don't put as much strain on it as on the styde nail, so we don't hear that about precise.

The LON nail is just one chunk of non-corrosive metal, without an interface that enables the nail to stretch out.
This should not happen with the LON nail since both the nail and screws are of the same non-corrosive metal. Exceptions are if the manufacturer delivers cheap/fake products, but let's not assume this.
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Dirona

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #4 on: April 09, 2022, 04:07:04 PM »

The way I see it, stryde (and precise) use different metals/materials at the interface, even if it's "coated", once liquid connects two different metals corrosion occurs. These nails should have been made entirely non-corrosive, instead of relying on a coating to prevent corrosion. I just guess that they have to be constructed like this, reading the reports.

With stryde no one is careful because it's weight bearing and so it wears out a bit, and we see cases of corrosion. Precise should have the same ratio of corrosion if the mechanism and metals at the interface are similar to stryde, but patients don't put as much strain on it as on the styde nail, so we don't hear that about precise.

The LON nail is just one chunk of non-corrosive metal, without an interface that enables the nail to stretch out.
This should not happen with the LON nail since both the nail and screws are of the same non-corrosive metal. Exceptions are if the manufacturer delivers cheap/fake products, but let's not assume this.

So you mean to say LON is safer than precice?
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Dirona

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #5 on: April 09, 2022, 04:32:21 PM »


Please watch this video by Dr. Lee
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Dexter5729

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Re: Very very imp(risk of corrosion related osteolysis)
« Reply #6 on: April 09, 2022, 06:22:33 PM »

So you mean to say LON is safer than precice?
He probly meant safer but with the cost of more pain, more scars, pinsite infections,..... But i would still do lon or pure external if i had to do this again. Old method still works
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