Incidence and Indications for Orthopaedic Implant Removal: A Retrospective Analysis

Background: Even though the need for routine removal of orthopaedic implants is an issue of controversy, it’s one of the commonest operations in bone and joint surgery. The purpose of this study was to examine the incidence and indications for orthopaedic implant removal at a hospital in Ghana. Methods: This retrospective study examined the health record files of all patients that had their orthopaedic implants removed at the Tania specialist hospital from January, 2011 to December, 2013. Using a standardised form information such as demographic characteristics, type of bone with implant, indication for implant removal, duration of implant before removal and type of implant removed were retrieved from the health record files of the patients.Results: Out of the 263 patients that had prior open reduction and internal fixation operation ( ORIF) and reported, requesting implant removal during the three year period under review, 36 patients (13.7%) had a second operative procedure for implant removal. The incidence of implant removal occurred twice in males compared to females. In both males (28.6%, n=7) and females (45.5%, n=5), most of the implants were removed from the femur bone (33.3%, n=12) followed by the tibia bone (27.8%, n=10). Those aged 31-40 years (36.1%, n=13) had the highest incidence of implant removal followed by those aged 21-30 years (25.0%, n=9). Generally, in both males (56.0%, n=14) and females (54.5%, n=6) patients’ request (55.6%, n=20) was the commonest indication for implant removal. In all patients aged < 10 years, surgeon’s request was the only indication for implant removal. Conclusion: The incidence of orthopaedic implant removal was found to be 13.9%. The commonest indication for implant removal in adults was patient request. Surgeon’s request was the commonest indication for orthopaedic implant removals in children.