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The Benefits of Implant Removal from the Foot and Ankle

Williams, Ariel A., MD1; Witten, Daniela M., PhD2; Duester, Rosanna, PhD, MS, PA-C3; Chou, Loretta B., MD3

doi: 10.2106/JBJS.J.01756
Scientific Articles
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Background: Following successful orthopaedic surgical procedures, implant removal is generally not necessary or recommended. However, patients with pain related to implants may benefit from this elective procedure. The foot and ankle may be more symptomatic from retained implants because of weight-bearing activities, shoe wear, and limited soft-tissue cushioning. In such cases, implant removal may provide good and reliable relief of symptoms.

Methods: A prospective study of sixty-nine patients who underwent elective removal of symptomatic implants from the foot and ankle was undertaken to evaluate the patients’ pain experience. The Short-Form McGill Pain Questionnaire was administered preoperatively and six weeks postoperatively. Postoperatively, patients were also asked whether they would repeat the procedure and whether they were satisfied with the results.

Results: Patients reported significantly less pain following the procedure, with the average rating of pain on the visual analog scale (VAS) decreasing from 3.06 to 0.88 and the average rating of present pain intensity decreasing from 2.03 to 0.58 (p < 0.05 for both). Sixty-five percent of the patients reported no pain on either measure at six weeks postoperatively. Preoperative pain was correlated with postoperative pain (r = 0.24 and p < 0.05 for VAS, and r = 0.16 and p > 0.05 for present pain intensity).With the small sample size, preoperative and postoperative pain did not show a significant difference on the basis of implant location or patient age or sex. Ninety-four percent of patients said they would repeat the procedure under the same circumstances, and 91% of patients were satisfied with the results.

Conclusions: Following successful orthopaedic surgical procedures, removal of implants causing symptoms can result in pain relief and a high rate of patient satisfaction.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopaedic Surgery, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287

2Department of Biostatistics, University of Washington, Box 357232, Seattle, WA 98195

3Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Redwood City, CA 94063. E-mail address for L.B. Chou: lchou@stanford.edu

Copyright © 2012 by The Journal of Bone and Joint Surgery, Incorporated
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