title: Outcomes and satisfaction of patients with orthopaedic implants left in-situ for more than three years: a retrospective study.
abstract: BACKGROUND
  There are no clear guidelines on implant removal. Few have assessed the long-term outcomes of patients with implants left in-situ, or removed. Therefore, removal of implants after fracture fixation remains controversial.
  
  
  METHODS
  In this retrospective study, we reviewed 53 patients with implant for fracture fixation in-situ for more than 3 years. All patients were younger than 60 years. Quality of life of each patient was assessed with the Chinese (Hong Kong) validated Short Form-36 and the pain was assessed with visual analogue scale (VAS). All patients were clinically examined and plain radiographs were taken.
  
  
  RESULTS
  The total SF-36 score of the patients was not statistically different from the Hong Kong norm (P > 0.05). Mean score of VAS was 2.08. Thirty-three patients (62.3%) reported limited range of movement, 9 patients (17%) complained of cosmetic problems, and 10 patients (18.9%) complained of weakness. Clinically, 82.6% of patients had no scarring, 84.7% of patients had full range of movement and all had no tenderness on assessment. Radiologically, no abnormality was detected except for one patient with known avascular necrosis of the femoral head after screw fixation.
  
  
  CONCLUSIONS
  As most patients were clinically and radiologically normal with quality of life scores comparable to the norm, removal of implants is not advisable as a routine practice.
authors.affiliation: Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
authors.forename: Aaran Heng-Chi
authors.initials: AH
authors.lastname: Leung
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Shen
authors.forename: Andraay Hon-Chi
authors.initials: AH
authors.lastname: Leung
authors.forename: Yuk-Wah
authors.initials: YW
authors.lastname: Hung
authors.forename: Anna H W
authors.initials: AH
authors.lastname: Mok
authors.forename: Wing-Hoi
authors.initials: WH
authors.lastname: Cheung
authors.forename: Kwok-Sui
authors.initials: KS
authors.lastname: Leung
mesh_terms: D000328:Adult; D001863:Bone Screws; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods*; D019736:Prostheses and Implants; D011859:Radiography; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome