Do orthopaedic surgeons need a policy on the removal of metalwork? A descriptive national survey of practicing surgeons in the United Kingdom

Remission rate of implant-related infections following revision surgery after fractures

“…(3) The indication for implant removal was influenced by the surgeon and the previous complaints of the patients. While implant removal upon infection in consolidated bone does not provoke much discussion, implant removal without infection or wound dehiscence remains controversial in the current literature [19,21]. Hence, for the first part of our study the low incidence of post-removal osteomyelitis might be biased by young and healthy trauma patients.…”

“…Theoretically, the Gram-negative rod P. aeruginosa is known to be particularly difficult to eradicate from osteoarticular and prosthetic joint tissue due to its extended biofilm-producing capacities, its natural resistance to a variety of antimicrobial agents and development of rapid resistance even during ongoing therapy. In the literature, osteoarticular infections due to P. aeruginosa regularly yield higher failure rates as compared to Gram-positive microorganisms, even if the difference is not always statistically significant [18][19][20].…”

Indications for implant removal after fracture healing: a review of the literature

“…Though there are several presumed benefits of implant removal, like functional improvement and pain relief, the surgical procedure can be very challenging and may lead to complications such as neurovascular injury and refractures, whereas the expected outcome is not well determined yet. The (medical) indications for surgical removal of these metal implants are not well defined and a variety of view points with large differences in opinions and practices between surgeons, countries, patients, anatomical locations and implant materials exist [1][2][3][4][5][6]. There is a lack of clear guidelines concerning implant removal, only in Germany a more or less consensus based guideline exists [7].…”

Risk Assessment of Tendon Attrition Following Treatment of Distal Radius Fractures With Volar Locking Plates Using Audible Crepitus and Placement of the Plate: A Prospective Clinical Cohort Study

“…In this study, a relatively higher percentage (66%) of patients underwent plate removal than the reported routine removal incidence (6%). 36 We advocated removal of volar plates to prevent possible tendon rupture, although it requires a surgical procedure with a certain morbidity and incidence of complications. Our study showed that specific patients had been encouraged to have plate removal, although the criteria for removal at our institution were not rigid and uniform.…”