Costs and complications of implant removal

Implant removal procedures are among the most frequently performed orthopaedic operations. Since they can have potentially severe complications, relative indications for such procedures have to be thoroughly considered especially when patients have no symptoms. Apart from such general complications as infection, the possibility of refractures, nerve lesions, pain arising for the first time after surgery and incomplete hardware removal must be borne in mind. The fixed-angle implants in particular have given rise to a new type of complications following hardware removal. These procedures cannot therefore be recommended except for symptomatic patients. In some countries, however, implant removal operations are the second most frequently performed group of orthopaedic-traumatological procedures, so that in addition to their significance for the national economy these procedures could increase case numbers and-depending on numerous variables-also enhance revenue. When the German DRG system is used as the basis for invoicing revenues can be optimised when operations are done fast and with few complications.