title: Metal implant removal: benefits and drawbacks--a patient survey.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany. reithg@kliniken-koeln.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Reith
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Schmitz-Greven
authors.affiliation: Helios Medical Center Wuppertal, ZBAF, Center for Biomedical Education and Research, Witten/Herdecke University, Witten, Germany.
authors.forename: Kai O
authors.initials: KO
authors.lastname: Hensel
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
authors.forename: Marco M
authors.initials: MM
authors.lastname: Schneider
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
authors.forename: Tibor
authors.initials: T
authors.lastname: Tinschmann
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
authors.forename: Bertil
authors.initials: B
authors.lastname: Bouillon
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Probst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D020878:Device Removal; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D055815:Young Adult
chemical_list: D008670:Metals