Table 3 Variables contributing to the likelihood of agreement in the different statements about general attitudes towards implant removal.
From: Surgeons' beliefs and perceptions about removal of orthopaedic implants
Statement | Surgeons' age | Male versus female surgeon | Orthopedic versus non-orthopedic surgeon | European versus US-American origin | European versus non-European origin | University versus other affiliation |
|---|---|---|---|---|---|---|
Orthopedic implants must be removed in younger patients (<40 years of age), even if they cause no problems | 1.03 (1.01–1.04) | 1.12 (0.74–1.70) | 1.23 (0.92–1.64) | 7.40 (3.77–14.50) | 1.56 (1.12–2.18) | 0.72 (0.54–0.97) |
Leaving implants in-situ poses a risk for later fractures | 0.99 (0.98–1.01) | 1.32 (0.86–2.02) | 1.13 (0.84–1.50) | 2.81 (1.44–5.47) | 0.98 (0.71–1.35) | 0.79 (0.59–1.06) |
Titanium implants are safer to be kept in-situ than devices made from stainless steel | 1.02 (1.00–1.04) | 0.82 (0.54–1.22) | 0.72 (0.54–0.96) | 2.16 (1.18–3.97) | 1.05 (0.76–1.45) | 1.04 (0.78–1.38) |
In case of otherwise unexplained pain and functional deficits, implant removal is a good option to improve the physical status | 1.00 (0.98–1.02) | 0.86 (0.53–1.38) | 0.73 (0.54–1.00) | 2.74 (1.47–5.11) | 1.81 (1.28–2.55) | 0.83 (0.61–1.13) |
Leaving implants in-situ increases the life-time risk for chronic infections, allergy, and cancer | 1.01 (0.99–1.03) | 1.14 (0.74–1.76) | 1.26 (0.94–1.68) | 1.66 (0.90–3.08) | 0.99 (0.72–1.37) | 0.92 (0.69–1.22) |
Removing implants is a surgical procedure which drains valuable hospital resources | 1.00 (0.98–1.02) | 1.51 (0.91–2.48) | 0.99 (0.72–1.38) | 1.39 (0.68–2.84) | 1.11 (0.77–1.60) | 1.08 (0.78–1.50) |
Removing implants damages healed soft tissue, and is riskier than retaining the device | 0.99 (0.97–1.00) | 1.06 (0.69–1.64) | 0.91 (0.68–1.22) | 1.20 (0.65–2.23) | 1.20 (0.65–2.23) | 1.36 (1.01–1.82) |
Given the time and efforts required for implant removal, this procedure is not adequately reimbursed by insurance companies | 1.02 (1.00–1.03) | 1.41 (0.93–2.14) | 1.43 (1.07–1.91) | 0.37 (0.19–0.70) | 0.37 (0.19–0.70) | 1.25 (0.93–1.67) |
Patients should take responsibility for the incurring costs of implant removal | 1.03 (1.01–1.05) | 2.39 (1.52–3.76) | 1.61 (1.20–2.16) | 0.48 (0.26–0.91) | 0.24 (0.17–0.34) | 1.31 (0.98–1.75) |