Diverse Views and Practices on the Handling of Explanted Hardware Highlights the Need for Standardized Management

Abstract

Objective: Orthopedic implants may need to be removed for various reasons. There is little data on the appropriate handling of implants after their removal from patients. This study aimed to analyze how orthopedic surgeons handle removed implants and their underlying philosophies, using data collected from a survey.

Methods: This study, conducted between May 2024 and June 2024, utilized an online survey targeting orthopedic surgeons and residents in Turkey to investigate practices and views regarding removed implants. A total of 205 participants completed an 11-question online survey via Google Forms. The survey covered hospital types, professional experience, protocols for handling removed implants, practices for archiving and disposing of implants, and perspectives on current practices and future direction.

Results: Participants' professional experience varied widely. None of the participants followed a specific protocol for managing removed implants. Opinions on giving implants to patients were diverse: 17.1% would never give the implant to the patient, 32.2% would comply with the patient's request, and 50.7% had no definitive approach. A minority (2.9%) systematically archived implants, while others archived selectively or disposed of them as medical waste. The primary motivations for archiving included medicolegal protection (21%) and professional curiosity (75.2%). Only 2.9% had experience with legal requests for removed implants, and 80% supported establishing regulations for handling removed implants.

Discussion: Orthopedic surgeons' legal and ethical perceptions regarding removed implants, as well as their preference of handling, vary widely. Establishing a standardized approach can reduce this variability in practice and ensure uniformity in healthcare.

Keywords

device / implant / removal / removed / survey

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RIGHTS & PERMISSIONS

2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.