The Role of Implant Removal in Orthopedic Trauma

Barcak, Eric; Beebe, Michael J.; Weinlein, John C.

doi:10.1016/j.ocl.2017.08.014

Cited by 14 publications

(21 citation statements)

References 53 publications

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“…Therefore, no consensus exists on the risks and benefits associated with implant removal. 2 , 8 , 11 12 13 14 15 16 17 18 19 20 21 22 23 Previous studies have shown improvement in pain and discomfort in as low as 53% of patients 22 and as high as 100% of patients. 17 Similar variation is seen in complication rates of implant removal with studies reporting a range from 0% 17 , 21 to 30%.…”

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confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

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Introduction: The relative indications for removing symptomatic implants after osseous healing are not fully agreed on. The purpose of this study was to (1) determine whether patients showed improvement in functional outcomes after the removal of symptomatic orthopaedic implants, (2) compare the outcomes between upper and lower extremity implant removal, and (3) determine the rate of implant removal complications. Methods: A prospective study was conducted between 2013 and 2016. Patients completed a Short Musculoskeletal Function Assessment outcome questionnaire before implant removal and at the 6-month follow-up. Demographic data were stratified and compared between upper and lower extremity groups and between preimplant removal and 6-month postremoval. Results: Of the 119 patients included in the study, 85 (71.4%) were lower extremity and 34 (28.6%) were upper extremity. Significant improvement after implant removal was seen in the dysfunction index ( P ≤ 0.001), bother index ( P ≤ 0.001), and daily activities domain ( P ≤ 0.001). Depression or anxiety ( P = 0.016) were statistically significant predictors for an improved Short Musculoskeletal Function Assessment dysfunction index score at 6 months. The complication rate was 10.1% (n=12) for the cohort. Discussion: Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.

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confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

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“…10 While exact rates of complications for revision surgery are patient and surgeon specific, they do not come without risk. 3 Limitations of this technique include the inability to completely remove all metal debris, the potential for thermal damage to adjacent structures, rough edges due to inadequate rasping, and possibility for iatrogenic damage with the high-speed burr.…”

Section: Discussionmentioning

confidence: 99%

“…Such risks include prolonged anesthesia, increased blood loss, increased postoperative pain and analgesia requirements, potential for neurovascular injury, and wound complications. 3 The authors present a simple technique for cutting orthopaedic plates, which is applicable to many types and sizes of implants. The technique reduces operating time, complications, and chance of foreign body inflammatory reaction from metal debris.…”

Section: Introductionmentioning

confidence: 99%

Use of high-speed burr and water-based lubricant in the partial removal of surgical plates: A technique Guide

Hammarstedt

Gershkovich

Mass

2019

Journal of Clinical Orthopaedics and Trauma

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Implant removal comprises 5% of all orthopaedic surgery procedures performed annually. Surgical indications range from implant failure, infection, non-union, and symptomatic hardware. Intraoperatively, surgeons need to prepare for complications including bony overgrowth, cold-welding, broken screws, and stripped screw heads. Large anatomic dissections required for complete hardware removal place the patient at increased risk of complications due to increased operating time and larger dissections. The authors present a safe and effective technique for the partial removal of surgical implants. The technique utilizes a high-speed burr to cut surgical plates, minimizing the total dissection and operative time. Sterile surgical laps covered in water-based lubricant capture metal debris to reduce tissue contamination as well as surgeon exposure to metal particles.

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“…However, regarding other relative indications which are the most frequently reasons for removal of implants (patient request, occasional implant discomfort, military recruitment), no clear established guidelines can be found, and even most of authors do not recommend its removal [1][2][3] . Even among patients with painful implants, debates about the reason of pain with respect to whether the pain is caused by the implants or the fracture itself are ongoing since even after removal, a chance that the pain will not improve is still present 3,[10][11] . This situation mandates careful evaluation of risks and potential complications in which benefits should outweigh potential damage and not to perform it as a routine surgery 1,2,10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…Even among patients with painful implants, debates about the reason of pain with respect to whether the pain is caused by the implants or the fracture itself are ongoing since even after removal, a chance that the pain will not improve is still present 3,[10][11] . This situation mandates careful evaluation of risks and potential complications in which benefits should outweigh potential damage and not to perform it as a routine surgery 1,2,10,11 . However, some studies report improvement in function and an increase in patient satisfaction after removal of their implants 2,8,12 .…”

Section: Introductionmentioning

confidence: 99%

Incidence of Orthopedic Implant Removal, its Indications, and the Effect of the Covid-19 Pandemic

Hendi¹,

Alsofyani²,

Mohammed³

2021

PJMHS

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Aims & Objective. To assess the incidence and rate of implant removal among orthopedic patients, its indications, and the effect of COVID-19 pandemic. Material & Method: A retrospective study was done during the period from October 2017 to October 2020 included all patients admitted for removal of orthopedic implants. Results: One-hundred eleven patients with a mean age of 28 ± 10.9 years were included in this study. Most (83.8%) were males. The incidence rate of removal was 20.2%. The mean period between implant fixation and removal was 26 ± 20 months. Lower limb fractures constituted 85.6% of cases with about half of them as foot and ankle fractures. The most frequently presented fractures were femur and tibia (33.3% and 21.6%, respectively), while the most frequently removed implants were plate and screws (43.2%). Only 8.9% of surgeries were indicated for removal, and only 4.5% of all patients suffered post-removal complications. Conclusion: Non indicated implant removal occurs at a significantly high rate in Saudi Arabia. No real indications for such a procedure were found in the majority of patients. COVID-19 control strategies caused a significant decrease in this high rate. Keywords: COVID19; Orthopedics; Incidence Rate; Kingdom of Saudi Arabia; Bone Pins

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The Role of Implant Removal in Orthopedic Trauma

Cited by 14 publications

References 53 publications

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Use of high-speed burr and water-based lubricant in the partial removal of surgical plates: A technique Guide

Incidence of Orthopedic Implant Removal, its Indications, and the Effect of the Covid-19 Pandemic

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