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Orthopedic Implant Removal in the Department of Orthopedics of a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

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Abstract: Introduction: Implant removal surgery is one of the common surgical procedures done in orthopedics. Studies report that a major portion of orthopedic surgeries carried out in different institutions comprises implant removal procedures. This can be challenging in limited manpower and infrastructure availability scenarios, like in developing countries like Nepal. This study aims to study the prevalence of orthopedic implant removal procedures carried out among overall surgical procedures in the orthopedic department of a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was performed on the medical records of the department of orthopedics of a tertiary care center after approval from the institutional review committee. The data included records from the starting of 2018 to the end of 2019. Data related to the number of implant removal procedures, types of implants, indications, fracture sites, anesthesia use, gender and age distribution were studied. Statistical Package for Social Sciences version 20 was used to study descriptive data. Results: Out of 2557 orthopedic operations carried out in the study duration, 458 (17.91%) of implant removal procedures were done in the department. The most common age group was the young adult age group, 255 (55.68%). Medium-sized implants were the commonly removed ones, 337 (73.58%). Elective procedures were the most common indication, 369 (80.57%). Conclusions: Implant removal procedures cover a major fraction of overall orthopedic operations carried out by the department, most of which are elective procedures. In limited-resource settings, this can be challenging, and a proper evaluation with counseling could be done before implant removal surgery.

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Ravi Bhandari Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0003-0113-0424 Pravakar Dawadi Nepalese Army Institute of Health Sciences, Bhandarkhal, Kathmandu, Nepal https://orcid.org/0000-0002-8355-429X Mohit Thapa Magar Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0002-3129-3390 Ritesh Sinha Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0001-6099-5941 Nirab Kayastha Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal Rajesh Pratap Shah Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0002-7485-5998 Bishnu Babu Thapa Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0003-1052-9488 Sushil Rana Magar Department of Orthopedics, Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal https://orcid.org/0000-0001-6778-6114

Keywords

elective surgical procedures, implants, orthopedic, surgery

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