Indications for implant removal: a prospective study

Abstract

<p class="abstract"><strong>Background:</strong> The implants removal after fracture healing has always been an issue of controversy. After union, the implant ceases to be important and can be removed. Nevertheless, some patients require metallic implant removal due to various implant-related difficulties. Our study was aimed to identify the most common causes for removal of implant.</p><p class="abstract"><strong>Methods:</strong> The patients admitted for implant removal in our department were consented and included in the study. Pre-operative radiological images collected and evaluated. Post-operatively, images were taken and followed for resolution of symptoms or appearance of new problems.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 60 patients were studied. Of these, 47 were males and 13 were females. Mean age was 33.7 years (range 4-70 years). Patient request (35% of patients) was the main indication for removal of implants. Reasons were found to be discomfort due to implant, infection, failure of implants and others.</p><p class="abstract"><strong>Conclusions:</strong> Belief regarding hardware removal has been set and most of them are agreed that routine removal should not be performed unless obviously indicated. In our attempt to fill this gap, we trust that routine removal should not be performed in ‘asymptomatic’ patients. The procedure should not need a big procedure than the implant fixation surgery. Procedure should be sought also as a risk like refracture, bleeding, infection, neurovascular injury and prior to surgery, proper consent to be taken and patient should be well explained. Sometimes indicated results expected after surgery can’t be fulfilled, and instead, complication can results.</p>

Indications for the removal of implants after fracture healing: A comparison between human and veterinary medicine

“…Although there are several advantages to implant removal, such as functional improvement and pain relief, the surgical procedure can be very challenging and may result in complications such as neurovascular injuries or refractures (Jain et al 2019). Indications for removal can be relative (not necessary) or absolute (when removal is obligatory), and the decision-making process is influenced by a variety of factors, i.e., surgery-related factors (differences between countries, hospital protocols), implant-related factors (type of material), patient-related factors (age, implant location, human or animal), or socioeconomical factors (insurance coverage, financial restraints) (Vos and Verhofstad 2013).…”

“…Small animal orthopaedics has developed enormously during the last few years. Recommendations in humans state that the removal of implants should not be performed routinely, but only in cases with clear indications such as implant-associated pain, implant failure, metal allergies, risk of periprosthetic fractures, functional limitations, or infection (Richards et al 1992;Muller-Farber 2003;Townend and Parker 2005;Vos et al 2012;Acklin et al 2018;Jain et al 2019).…”