Study of implant removal due to various indications in a tertiary care hospital - A retrospective Study

Abstract

Fracture management have improve along with the advance of technology. Depending on bone and site of fracture, latest contour plates and nails are available. Even after the advance in implant material. On the other hand, controversy still persist among surgeons on cardinal indication required for implants removal. Implant removal mainly depend on the patient's symptoms. The aim of the study to detect the main causes for implant removal. Objective: To survey the primary cause for implant removal along with detecting which implants requires removal in orthopaedic surgeries. Materials and Methods: All adult patients who were admitted for implant removal in the orthopaedic ward. Results: A study group of 89 patients, 73 males and 16 females. The mean age of the study group was 38 years. The causes for implant removal were sorted into four categories: 1) Pain/discomfort, 2) Infection, 3) implant failure or resorption 4) Elective (patient's choice). Depending on our survey, implants frequently removed are distal Tibial/Ankle plates (14.45%), Femoral Intramedullary (IMIL) nails (13.25%), Olecranon both wires and plates (12.04%), Tibial IMIL nails and Patellar tension band wires (9.53%). Discussion and Conculusion: Clinical indications for implant removal has not been properly specified. According to our study pain / discomfort was the most dominant reason for implant removal (37.1%). The second common indication was infection (26.96%) removing the implant was mandatory. Third indication was Implant failure in symptomatic patients as a result of poor quality implants, inadequate or faulty implant and uncooperative patients. Fourth indication was on patients demand. Implant removal is a laborious surgery as factors like bone ingrowth and wear of the implants which makes it an onerous removal.