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A novel implant removal technique by endoscopy.

A novel implant removal technique by endoscopy.
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Liu CH, Yeh WL, Tsai PJ, Fan KF, Cheng HW, Chen JM,


Liu CH, Yeh WL, Tsai PJ, Fan KF, Cheng HW, Chen JM, (click to view)

Liu CH, Yeh WL, Tsai PJ, Fan KF, Cheng HW, Chen JM,

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Journal of orthopaedic surgery and research 2018 04 0613(1) 74 doi 10.1186/s13018-018-0783-4
Abstract
BACKGROUND
Routine implant removal after fracture healing remains controversial. However, it has been suggested that implant removal should be performed in cases of joint impingement, painful scar adhesion, and implant malposition. Entrance selection is relatively critical in patients with poor soft tissue conditions or sloughing coverage. We propose an innovative technique using endoscopy.

METHODS
Consecutive surgeries of endoscopic implant removal performed between 2005 and 2016 by a single experienced arthroscopic surgeon were included. Overall, 73 patients were enrolled; 44 were not eligible for inclusion and were excluded from the study.

RESULTS
Twenty-nine patients, including 32 surgical sites, were included. Twenty-four plates and 166 screws were removed using this technique. There were five complications during the follow-up period (range, 0.5 to 104 months; mean, 8.8), including one broken screw, one persistent knee joint contracture, and three wound dehiscence. There were no infections or neurovascular injuries.

CONCLUSION
Implant removal using endoscopy is a minimally invasive surgery that ensures that the screw axis does not strip, and treats the intra-articular pathology concomitantly. This innovative technique may be considered as an alternative to the traditional open method in cases with good surgical indications.

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