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Published in: BMC Surgery 1/2015

Open Access 01-12-2015 | Research article

Metal implant removal: benefits and drawbacks – a patient survey

Authors: Georg Reith, Vera Schmitz-Greven, Kai O. Hensel, Marco M. Schneider, Tibor Tinschmann, Bertil Bouillon, Christian Probst

Published in: BMC Surgery | Issue 1/2015

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Abstract

Background

Hardware 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.

Methods

We 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.

Results

In 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.

Conclusion

In 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.
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Literature
1.
go back to reference Bostman O, Pihlajamaki H. Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units. J Trauma. 1996;41(5):846–9.CrossRefPubMed Bostman O, Pihlajamaki H. Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units. J Trauma. 1996;41(5):846–9.CrossRefPubMed
3.
go back to reference Unno Veith F, Ladermann A, Hoffmeyer P. Is hardware removal a necessity? Rev Med Suisse. 2009;5(201):977–80.PubMed Unno Veith F, Ladermann A, Hoffmeyer P. Is hardware removal a necessity? Rev Med Suisse. 2009;5(201):977–80.PubMed
4.
go back to reference Busam ML, Esther RJ, Obremskey WT. Hardware removal: indications and expectations. J Am Acad Orthop Surg. 2006;14(2):113–20.CrossRefPubMed Busam ML, Esther RJ, Obremskey WT. Hardware removal: indications and expectations. J Am Acad Orthop Surg. 2006;14(2):113–20.CrossRefPubMed
5.
go back to reference Muller-Farber J. Metal removal after osteosyntheses. Indications and risks. Der Orthopade. 2003;32(11):1039–57. quiz 58.CrossRefPubMed Muller-Farber J. Metal removal after osteosyntheses. Indications and risks. Der Orthopade. 2003;32(11):1039–57. quiz 58.CrossRefPubMed
7.
go back to reference Brown RM, Wheelwright EF, Chalmers J. Removal of metal implants after fracture surgery--indications and complications. J R Coll Surg Edinb. 1993;38(2):96–100.PubMed Brown RM, Wheelwright EF, Chalmers J. Removal of metal implants after fracture surgery--indications and complications. J R Coll Surg Edinb. 1993;38(2):96–100.PubMed
8.
9.
go back to reference Richards RH, Palmer JD, Clarke NM. Observations on removal of metal implants. Injury. 1992;23(1):25–8.CrossRefPubMed Richards RH, Palmer JD, Clarke NM. Observations on removal of metal implants. Injury. 1992;23(1):25–8.CrossRefPubMed
10.
go back to reference Evers B, Habelt R, Gerngroß H. Indication, timing and complications of plate removal after forearm fractures: results of a metaanalyses including 635 cases. J Bone Joint Surg Br. 2004;86-B(SUPP III):289. Evers B, Habelt R, Gerngroß H. Indication, timing and complications of plate removal after forearm fractures: results of a metaanalyses including 635 cases. J Bone Joint Surg Br. 2004;86-B(SUPP III):289.
11.
go back to reference Beaupre GS, Csongradi JJ. Refracture risk after plate removal in the forearm. J Orthop Trauma. 1996;10(2):87–92.CrossRefPubMed Beaupre GS, Csongradi JJ. Refracture risk after plate removal in the forearm. J Orthop Trauma. 1996;10(2):87–92.CrossRefPubMed
19.
go back to reference Esenwein P, Sonderegger J, Gruenert J, Ellenrieder B, Tawfik J, Jakubietz M. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg. 2013;133(8):1155–62. doi:10.1007/s00402-013-1766-x.CrossRefPubMed Esenwein P, Sonderegger J, Gruenert J, Ellenrieder B, Tawfik J, Jakubietz M. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg. 2013;133(8):1155–62. doi:10.​1007/​s00402-013-1766-x.CrossRefPubMed
20.
21.
go back to reference Rehn CH, Kirkegaard M, Viberg B, Larsen MS. Operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review. Eur J Orthop Surg Traumatol. 2013. doi:10.1007/s00590-013-1370-3. Rehn CH, Kirkegaard M, Viberg B, Larsen MS. Operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review. Eur J Orthop Surg Traumatol. 2013. doi:10.​1007/​s00590-013-1370-3.
22.
go back to reference Martin CT, Pugely AJ, Gao Y, Wolf BR. Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database. J Bone Joint Surg Am. 2013;95(14):e98 1–10. doi:10.2106/jbjs.l.01440.CrossRef Martin CT, Pugely AJ, Gao Y, Wolf BR. Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database. J Bone Joint Surg Am. 2013;95(14):e98 1–10. doi:10.​2106/​jbjs.​l.​01440.CrossRef
24.
26.
go back to reference Brown OL, Dirschl DR, Obremskey WT. Incidence of hardware-related pain and its effect on functional outcomes after open reduction and internal fixation of ankle fractures. J Orthop Trauma. 2001;15(4):271–4.CrossRefPubMed Brown OL, Dirschl DR, Obremskey WT. Incidence of hardware-related pain and its effect on functional outcomes after open reduction and internal fixation of ankle fractures. J Orthop Trauma. 2001;15(4):271–4.CrossRefPubMed
27.
go back to reference Court-Brown CM, Gustilo T, Shaw AD. Knee pain after intramedullary tibial nailing: its incidence, etiology, and outcome. J Orthop Trauma. 1997;11(2):103–5.CrossRefPubMed Court-Brown CM, Gustilo T, Shaw AD. Knee pain after intramedullary tibial nailing: its incidence, etiology, and outcome. J Orthop Trauma. 1997;11(2):103–5.CrossRefPubMed
29.
go back to reference Tucker A, Street J, Kealey D, McDonald S, Stevenson M. Functional outcomes following syndesmotic fixation: a comparison of screws retained in situ versus routine removal - Is it really necessary? Injury. 2013. doi:10.1016/j.injury.2013.08.011. Tucker A, Street J, Kealey D, McDonald S, Stevenson M. Functional outcomes following syndesmotic fixation: a comparison of screws retained in situ versus routine removal - Is it really necessary? Injury. 2013. doi:10.​1016/​j.​injury.​2013.​08.​011.
30.
go back to reference Gosling T, Hufner T, Hankemeier S, Zelle BA, Muller-Heine A, Krettek C. Femoral nail removal should be restricted in asymptomatic patients. Clin Orthop Relat Res. 2004;423:222–6.CrossRef Gosling T, Hufner T, Hankemeier S, Zelle BA, Muller-Heine A, Krettek C. Femoral nail removal should be restricted in asymptomatic patients. Clin Orthop Relat Res. 2004;423:222–6.CrossRef
Metadata
Title
Metal implant removal: benefits and drawbacks – a patient survey
Authors
Georg Reith
Vera Schmitz-Greven
Kai O. Hensel
Marco M. Schneider
Tibor Tinschmann
Bertil Bouillon
Christian Probst
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2015
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-015-0081-6

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