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A Compatibility Guide for the Orthopaedic Surgeon Planning to Perform Hardware Removal Surgery

Riedel, Matthew D., MD; Cronin, Patrick K., MD; Kaiser, Philip B., MD; Kwon, John Y., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 15, 2019 - Volume 27 - Issue 2 - p e92–e95
doi: 10.5435/JAAOS-D-17-00658
Research Article

Background: Removal of previously placed orthopaedic implants is a commonly performed procedure worldwide. Given the diversity of orthopaedic implant manufacturers, surgeons may be uncertain whether they have the appropriate screwdriver on site. The purpose of this study was to assess the compatibility of screw head and size configurations from various orthopaedic manufacturers with two commonly used universal screw removal sets.

Methods: Inclusion of orthopaedic implant manufacturers was determined by market share based on industry-monitoring financial firms. Screw size and drive type for the top grossing orthopaedic implant manufacturers were collected and recorded. Screw and screwdriver compatibility was assessed and compared with two commonly used universal screw removal sets.

Results: In total, six orthopaedic implant companies with commonly implanted screws throughout the appendicular skeleton were included. The data were compiled in table format with noncannulated, cannulated, and locking screw offerings separated by the screw size and manufacturer. Guidewire size compatibility for cannulated offerings was also assessed.

Conclusions: Given the ubiquity of implanted orthopaedic implant, removal must be as safe, planned, and controlled as possible. The data in this article provide an inclusive, centralized resource for surgeons looking to confirm the compatibility of previously implanted screws and available removal equipment at their institution.

From the Harvard Combined Orthopaedic Residency Program (Dr. Riedel, Dr. Cronin, and Dr. Kaiser), and the Department of Orthopaedic Surgery (Dr. Kwon), Beth Israel Deaconess Medical Center, Boston, MA.

Correspondence to Dr. Riedel:

Dr. Riedel or an immediate family member serves as a paid consultant to Paragon 28 and serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association. Dr. Kwon or an immediate family member has received royalties from Paragon 28 and TriMed; serves as a paid consultant to Medline, MedShape, and Paragon 28; and has stock or stock options held in MedShape. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Cronin and Dr. Kaiser.

© 2019 by American Academy of Orthopaedic Surgeons
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