Metal implant removal: benefits and drawbacks – a patient survey

Abstract

BackgroundHardware removals are among the most commonly performed surgical procedures worldwide. Current literature offers little data concerning postoperative patient satisfaction. The purpose of our study was to evaluate the patients’ point of view on implant removal.MethodsWe surveyed patients of a German level one trauma center, who underwent hardware removal in 2009 and 2010, with regard to their personal experiences on implant removal. Exclusively, data obtained out of the survey were analyzed.ResultsIn 332 patients surveyed, most hardware removals were performed at the ankle joint (21 %) followed by the wrist (15 %). The most frequent indication was a doctor’s recommendation (68 %), followed by pain (31 %) and impaired function (31 %). Patient reported complication rate of implant removal was 10 %. Importantly, after implant removal because of pain or impaired function patients reported an improvement in function (72 %) as well as decreased pain (96 %). 96 % of all responding patients and 66 % of the patients who suffered from subsequent complications would opt for surgical implant removal again.ConclusionIn summary, despite the challenging and frequently troublesome nature of surgical hardware removal our data contradicts the widely held view that implant removal is often without a positive effect on the patients. These findings may influence the surgeons’ attitude towards implant removal and their day-to-day routine in patient counseling.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-015-0081-6) contains supplementary material, which is available to authorized users.

İmplant Çikariminda Endi̇kasyon Ve Kompli̇kasyon İli̇şki̇si̇

“…Sanderson et al reported a complication rate of 19,7 % following removal of implants and the most common complication was infection (10). Reith et al found that impaired wound healing was the most common complication in their study (5). The majority of our complications occured due to previous pathologic conditions of implant removal such as infection, pseudoarthrosis, implant failure.…”

“…Removal of the implant after internal fixation of bone fractures is one of the most commonly performed orthopedic operations (5). Implant removal surgery seems simple however, can lead to further complications such as; neurovascular injury, refracture, recurrence of deformity, delayed wound healing, new incident pain, broken implant, limitation in range of motion, wound infection, postoperative bleeding, incomplete removal (3,5,6).…”

Development of magnesium implants by application of conjoint‐based quality function deployment

“…In 2010, about 180,000 implants were removed in Germany, making this type of surgery the fourth most common orthopedic operation after fracture treatments, arthroscopic joint treatments and intervertebral disc interventions (Ochs et al, ). Reith et al () report on the results of a study with 332 patients in a German level‐one trauma center, where the complication rate associated with the removal of hardware was 10%. Depending on the study design, the implants and the location in the human body, other investigations have reported heterogeneous complication rates of up to 40% (Backes, Schep, Luitse, Goslings, & Schepers, ; Beaupre & Csongradi, ; Brown, Wheelwright, & Chalmers, ; Evers, Habelt, & Gerngroß, ; Minkowitz, Bhadsavle, Walsh, & Egol, ; Richards, Palmer, & Clarke, ; Stuby et al, ).…”

“…Depending on the study design, the implants and the location in the human body, other investigations have reported heterogeneous complication rates of up to 40% (Backes, Schep, Luitse, Goslings, & Schepers, 2013;Beaupre & Csongradi, 1996;Brown, Wheelwright, & Chalmers, 1993;Evers, Habelt, & Gerngroß, 2004;Minkowitz, Bhadsavle, Walsh, & Egol, 2007;Richards, Palmer, & Clarke, 1992;Stuby et al, 2012). According to the study of Reith et al (2015), the most frequent postoperative complications were wound healing disorders (36%), infections (21%), damage to neural tissue (14%), incomplete removal (12%), and other issues such as re-fracturing, bleeding, thrombosis, and keloid development (18%). In addition to the health risks of removal surgeries and the extended healing process, the socio-economic impact due to additional costs for hospitals and healthcare resources (Bostman & Pihlajamaki, 1996) as well as sick leave in a society's labor force (Busam, Esther, & Obremskey, 2006) is also mentioned in the literature.…”

Composite Calcium Phosphate/Titania Scaffolds in Bone Tissue Engineering

“…There is some evidence indicating that the postoperative complication rate depends on the specific localization of the implanted material [8].…”