Metal implant removal: benefits and drawbacks – a patient survey

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

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. 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. 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. 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.