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Modes of Failure of Custom Expandable Repiphysis ProsthesesA Report of Three Cases
Aditya V. Maheshwari, MD1; Patrick F. Bergin, MD2; Robert M. Henshaw, MD3
1 Department of Orthopedics and Rehabilitation, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203. E-mail address: adityavikramm@gmail.com
2 Division of Trauma, Department of Orthopaedic Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
3 Department of Orthopedic Oncology, Washington Hospital Center, 110 Irving Street N.W., Washington, DC 20010
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by the authors of this work are available with the online version of this article at jbjs.org.

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Investigation performed at the Department of Orthopedic Oncology, Washington Hospital Center, Washington, DC

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Jul 06;93(13):e72 1-7. doi: 10.2106/JBJS.J.00841
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Limb preservation surgery for patients with sarcomas of the extremity is recognized as a valid, safe, and effective means of treating local disease1. However, one of the major dilemmas in lower limb preservation in skeletally immature children is the ability to maintain leg-length equality as the child ages and grows. Many prosthetic designs that allow expansion of the internal prosthesis and consequent limb-lengthening, either noninvasively or through a minor surgical procedure, have evolved2,3. One of the latest of the noninvasive expandable implants is the Repiphysis expandable limb salvage system (Wright Medical Technology, Arlington, Tennessee), originally called the Phenix prosthesis (Phenix Medical, Paris, France)4,5. Although used in Europe since the early 1990s, the first Phenix prosthesis was implanted in the United States in 1998, and in 2002, the device became approved by the Food and Drug Administration. While this system offers many advantages over earlier expandable limb salvage implants, we observed three failures among sixteen Repiphysis prostheses implanted (in fourteen patients) between 2003 and 2010 by the senior author (R.M.H.). The patients and their parents were informed that the data concerning these cases would be submitted for publication, and they consented.
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