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REMOVAL OF TITANIUM IMPLANTS : A PROBLEM?



Abstract

The purpose of this study was to document difficulties encountered by orthopaedic surgeons with the removal of titanium implants.

A postal questionnaire was sent to all members of the New Zealand Orthopaedic Association seeking to document difficulties with the removal of titanium implants: screws, plates or intramedullary nails. The questionnaire included length of device implantation, estimated increase in theatre operating time over the expected time for the procedure, and complications encountered during the device removal.

Twenty six surgeons responded to the study. Six reported no difficulties in removing implants, 18 reported significant difficulties, and 2 had not had to remove titanium implants. Of the 18 surgeons reporting difficulties, 10 had problems with intramedullary nails, 4 with plates, 6 with screws and 1 with another device. The estimated increase in operating time varied between 20 and 140 minutes. Major complications reported included breaking intramedullary nails, screw heads shearing off, and damage to the underlying bone.

This survey demonstrates significant problems in removing titanium implants. Surgeons need to be aware that when using these devices difficulties with their removal can be encountered and patients should be warned that further injury may be sustained during device removal.

The abstracts were prepared by Jean-Claude Theis. Correspondence should be addressed to him at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.