Indications, outcomes, and complications of orthopaedic implant removal: a prospective observational study

Authors

  • Jyoti Gupta Department of Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune Maharashtra, India
  • Gururaj Joshi Department of Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune Maharashtra, India
  • Nishant Mirchandani Department of Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243128

Keywords:

Fracture management, Hardware removal, Orthopaedic implants, Postoperative complications, Patient outcomes, Surgical indications

Abstract

Background: Orthopaedic implant removal is a common procedure, but its indications and outcomes remain debated. This study aimed to examine the indications, outcomes, and complications of implant removal in a tertiary care center.

Methods: A prospective observational study was conducted on 66 patients undergoing implant removal between February 2022 and February 2024. Patient demographics, indications for removal, time to removal, and complications were recorded. Follow-ups were conducted at 6 weeks, 3 months, and 6 months post-removal.

Results: The study included 47 males and 19 females, with 74% adults and 26% paediatric patients. Pain was the most common indication for removal (42%), followed by elective removal (36%). Most implants (33%) were removed after 2 years. Complications were minimal, with 4.5% incomplete removals and 1.5% failure to remove. No intraoperative fractures or postoperative infections were observed. Patients generally reported improvement in symptoms or psychological well-being following implant removal.

Conclusion: Implant removal should be approached selectively, with careful consideration of indications and potential complications. Pain relief and improved function were common outcomes, but risks such as incomplete removal should be considered. The study supports individualized decision-making in implant management, emphasizing the need for thorough preoperative planning and skilled surgical execution.

Metrics

Metrics Loading ...

References

McElvany MD, Hak DJ. Removal of broken hardware. J Am Acad Orthop Surg. 2008;16(2):113-20.

Busam ML, Esther RJ, Obremskey WT. Hardware removal: indications and expectations. J Am Acad Orthop Surg. 2006;14(2):113-20.

Vos DI, Verhofstad MH. Indications for implant removal after fracture healing: a review of the literature. Eur J Trauma Emerg Surg. 2013;39(4):327-37.

Reith G, Schmitz-Greven V, Hensel KO, et al. Metal implant removal: benefits and drawbacks--a patient survey. BMC Surg. 2015;15:96.

Peterson HA. Metallic implant removal in children. J Pediatr Orthop. 2005;25(1):107-15.

Hanson B, van der Werken C, Stengel D. Surgeons' beliefs and perceptions about removal of orthopaedic implants. BMC Musculoskelet Disord. 2008;9:73.

Jamil W, Allami M, Choudhury MZ, et al. Do orthopaedic surgeons need a policy on the removal of metalwork? A descriptive national survey of practicing surgeons in the United Kingdom. Injury. 2008;39(3):362-7.

Mue DD, Yongu WT, Salihu MN, et al. Indications for removal of orthopaedic implants in a nigerian tertiary hospital: a review of 128 cases. West Afr J Med. 2021;38(2):166-70.

Böstman O, Pihlajamäki H. Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units. J Trauma. 1996;41(5):846-9.

Gupta J, Joshi GR. A prospective observational study of implant removal, its indications, outcomes and complications. Bharati Vidyapeeth Deemed University Medical College. Int J Health Sci (Qassim). 2017;11(1):1-7

World medical association. world medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.

Von Elm E, Altman DG, Egger M. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9.

Kocher MS, Zurakowski D. Clinical epidemiology and biostatistics: a primer for orthopaedic surgeons. J Bone Joint Surg Am. 2004;86(3):607-20.

Bhandari M, Swiontkowski MF, Einhorn TA. Interobserver agreement in the application of levels of evidence to scientific papers in the American volume of the Journal of Bone and Joint Surgery. J Bone Joint Surg Am. 2004;86(8):1717-20.

Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. Berlin, Heidelberg: Springer Berlin Heidelberg. 1990. Avialble at: https://www.scirp.org.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-55.

Swiontkowski MF, Engelberg R, Martin DP, Agel J. Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness. J Bone Joint Surg Am. 1999;81(9):1245-60.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The upper extremity collaborative group (UECG). Am J Ind Med. 1996;29(6):602-8.

Haseeb M, Butt MF, Altaf T, Gupta A, Jallu A. Indications of implant removal: A study of 83 cases. Int J Health Sci (Qassim). 2017;11(1):1-7.

Mue DD, Yongu WT, Salihu MN, Kortor JN, Elachi IC, Donwa JO. Indications for Removal of Orthopaedic Implants in a Nigerian Tertiary Hospital: A Review of 128 Cases. West Afr J Med. 2021;38(2):166-70.

Jamil W, Allami M, Choudhury MZ, Mann C, Bagga T, Roberts A. Do orthopaedic surgeons need a policy on the removal of metalwork? A descriptive national survey of practicing surgeons in the United Kingdom. Injury. 2008;39(3):362-7.

Vos DI, Verhofstad MH. Indications for implant removal after fracture healing: a review of the literature. Eur J Trauma Emerg Surg. 2013;39(4):327-37.

Reith G, Schmitz-Greven V, Hensel KO, Schneider MM, Tinschmann T, Bouillon B, Probst C. Metal implant removal: benefits and drawbacks--a patient survey. BMC Surg. 2015;7;15:96.

Sanderson PL, Ryan W, Turner PG. Complications of metalwork removal. Injury. 1992;23(1):29-30.

Georgiadis GM, Gove NK, Smith AD, Rodway IP. Removal of the less invasive stabilization system. J Orthop Trauma. 2004;18(8):562-4.

Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-7.

Bhattacharyya T, Iorio R, Healy WL. Rate of and risk factors for acute inpatient mortality after orthopaedic surgery. J Bone Joint Surg Am. 2002;84(4):562-72.

Busam ML, Esther RJ, Obremskey WT. Hardware removal: indications and expectations. J Am Acad Orthop Surg. 2006;14(2):113-20.

Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;28:167.

Downloads

Published

2024-10-25

How to Cite

Gupta, J., Joshi, G., & Mirchandani, N. (2024). Indications, outcomes, and complications of orthopaedic implant removal: a prospective observational study. International Journal of Research in Orthopaedics, 10(6), 1312–1318. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243128

Issue

Section

Original Research Articles