Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Evidence-Based Analysis of Removal of Orthopaedic Implants in the Pediatric Population

Raney, Ellen M. MD*; Freccero, David M. MD; Dolan, Lori A. PhD; Lighter, Donald E. MD§; Fillman, Ramona R. MHA, PT*; Chambers, Henry G. MD

doi: 10.1097/BPO.0b013e3181875b60
Special Report: The Pediatric Orthopaedic Society of North America's Evidenced Based Medicine Committee: Original Article

Background: Requested project of the Pediatric Orthopaedic Society of North America Evidenced-Based Medicine Committee.

Methods: The English literature was systematically reviewed for scientific evidence supporting or disputing the common practice of elective removal of implants in children.

Results: Several case series reported implant removal, but none contained a control group with retained implants. No articles reported long-term outcomes of retained implants in large numbers. Several small series describe complications associated with retained implants without evidence of causation. The existing literature was not amenable to a meta-analysis.

By compiling data from the literature, it is possible to calculate a complication rate of 10% for implant removal surgery. The complication rate for removal of implants placed for slipped capital femoral epiphysis is 34%. Articles regarding postmarket implant surveillance and basic science were also reviewed.

Conclusions: There is no evidence in the current literature to support or refute the practice of routine implant removal in children.

From the *Shriners Hospitals for Children-Honolulu; and †Tripler Army Medical Center, Orthopaedic Surgery Service, Honolulu, HI; ‡Department of Orthopaedics and Rehabilitation, University of Iowa Hospital, Iowa City, IA; §Shriners Hospitals for Children-Tampa, Tampa, FL; and ∥Children's Specialists-San Diego, San Diego, CA.

None of the authors received funding for this study.

Reprints: Ellen M. Raney, MD, 1310 Punahou St, Honolulu, HI 96826. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.