Bones have a unique ability to heal after damage. However, in certain cases of trauma, your injured bones may require help to align properly and heal and that is where orthopedic implants can help. Implants can be used for a variety of surgical procedures. An orthopedic surgeon may use implants to reconstruct a damaged joint, repair a bone fracture, or change your body’s skeletal alignment.
Intramedullary rods, pins, and other implants help bones to heal faster by holding things in place while the body heals. They are typically meant to stay in the body forever but there are cases when removing the hardware may be necessary.
What Are Orthopedic Implants?
Orthopedic implants are medical devices used to provide fixation for the bone. In this method, surfaces of the joints are replaced in the human body using these implants. They also help surgeons to replace, fix and even strengthen joints in the damaged areas. Because of the complications of this type of surgery, only highly skilled surgeons, specialized in this particular field, perform orthopedic implants.
Orthopedic implants can be categorized under two groups: permanent replacement of joints and temporary replacement. Permanent orthopedic implants are the implants for the hips, knees, ankles, shoulders, wrists and joints of the fingers, whereas plates, screws, pins, wires etc. are temporary implants.
The orthopedic surgeon inserts the implants into the body through various surgical methods, depending on the patient’s condition. If a joint is worsened beyond a specific point, the surgeon removes the injured joint and then replaces it with an orthopedic implant while utilizing various orthopedic instruments specially designed for the surgery.
Most orthopedic implants are made of titanium alloys and stainless steel, and a few of them may even be lined with plastic. The metallic structure provides the implant with the necessary strength, while the plastic lining serves as artificial cartilage. Typically, the implant is fitted into place, enabling the bone to grow into it for improved strength. In some cases, the surgeon may also cement the orthopedic implant to enhance adhesion.
Types of Orthopedic Implants
Now let’s look at the various types of orthopedic implants and their uses.
Screws
Orthopedic surgeries are impossible without the use of orthopedic screws. Orthopedic screws are one of the tenets in the process of orthopedic fixation. The bone heals better and faster if the fractures are pressed together firmly by orthopedic screws. The advantage of these screws is that they decrease the gap between the bones, and, consequently, decrease the stress, which is on the orthopedic implant as well.
Orthopedic screws are also known as to be one of the omnipresent hardware devices used in the surgeries, that may either be used by themselves to provide fixation, or in synchrony with other devices. The advantage of these screws is that they protect the fractured bone from bending, getting rotated, and trivial loading forces.
Plates
The main application of orthopedic plates and screws is fixation. But what is fixation? Bone fracture fixation is a technique that uses plates to stabilize the fractured bone, allowing it to heal faster and return to early mobility and full function more quickly. In this method, both sides of the bone are fixed with screws to stabilize the fracture and heal it in proper form. Bone plates are often used to repair fractures. Plates offer the advantages of anatomic reduction of the fracture with open techniques and stability for the early function of muscle-tendon units and joints, but they must be secured from premature weight-bearing.
Prostheses
Yet another type of orthopedic implant, prosthesis, is used to replace missing bones or joints. It may also be used to provide the support required by damaged bones. This implant is typically used for knees and hips and enables patients to regain their physical strength and activity in a relatively short time frame. Sometimes, the surgeon may combine prosthetic materials with healthy bones to replace damaged or diseased bones or to replace certain parts of a bone entirely.
Why Remove Hardware?
In the vast majority of patients with metal in the body, there is no need to remove the metal. Metal implants are generally designed to remain in place forever. However, there are some circumstances where metal should be removed. These include temporary metal devices only intended to be in the body for a short time, loose metal, or metal that may need to be removed to allow for additional surgery.
There should always be a good reason to remove metal from the body because needless hardware removal can open the door to possible complications of surgery.
When Should Hardware Be Removed
There are times when hardware removal can lead to significant benefits. When implanted metal is causing interference with normal joint mobility and function, or if metal implants are causing pain or irritation to soft-tissues, their removal can be beneficial.
In some cases, the hardware is routinely removed to prevent possible problems, and in other cases, the metal is only removed if it begins to cause a problem. There are also times when hardware removal becomes impossible.
This is often the case when there is a broken metal implant inside the body, which can be normal or expected in some cases after the surrounding bone has healed, and not necessarily a problem for the patient.
How to Prepare for Hardware Removal
Your surgeon will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery. Tell your surgeon about all the medicines you currently take. He or she will tell you if you need to stop any medicine before surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery. Tell your surgeon about all your allergies. Tell him or her if you had an allergic reaction to any medicine, including antibiotics or anesthesia.
What Happens During Hardware Removal?
You may be given general anesthesia to keep you asleep during surgery. You may instead have local anesthesia to numb the area where you are having surgery. You will be awake during the surgery if you have local anesthesia. You may also receive medicine to keep you calm and relaxed during surgery.
An incision will be made near the location of your hardware. Your surgeon may use the original surgery incision or create a new incision. Your surgeon will use small tools to loosen and remove the hardware. Scar tissue that formed around the hardware may also need to be removed. The hardware may be removed or replaced with new hardware. The incision will be closed with stitches. A bandage will cover your incision to help prevent infection.
Your Recovery
Once you have had surgery to remove orthopedic hardware such as metal screws, pins or plates, you can expect some pain and swelling around the cut (incision) the doctor made. This should get better within a few days and up to several weeks.
Your doctor will tell you when it is okay to return to work or other activities.
How Can You Care for Yourself at Home?
Activity
Get plenty of rest and be sure to take it easy when you feel tired. Getting enough sleep will help you recover. Avoid using or putting weight on the area where the hardware was removed until your doctor says it is okay.
Increase your activity as recommended by your doctor. Being active boosts blood flow and helps prevent pneumonia and constipation. It is usually okay to exercise other parts of your body as soon as you feel well enough.
You might need to take time off from work. It will depend on the type of hardware that was removed, where it was located, and the reason it was removed. It will also depend on the type of work you do and how you feel.
Diet
You should be able to eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast and yogurt.
Medications
You will be provided with a prescription for a pain medication when you are ready to leave the hospital. Usually, we will prescribe hydrocodone, hydromorphone, or oxycodone. These are generic names for three different narcotic pain relievers. If you are aware of a certain pain medication that you have previously had problems with or one that you normally respond favorably to, please inform us so that we can give you the appropriate prescription. You may have the prescription prior to surgery to avoid filling it the day of surgery.
You might also be given a prescription for an anti-inflammatory medication Toradol (ketorolac) that will help lessen pain and swelling. If not, you are welcome to use an over-the-counter anti-inflammatory such as Ibuprofen (Advil, Nuprin, etc.). These come in 200-mg tablets. The usual maximum adult prescription dosage is 400-600 mg 3-4 times per day, usually taken with food.
Plain Tylenol is OK if you have no liver disease. Remember, the short acting pain pills often have acetaminophen (Tylenol) in them. The maximum daily dose of Tylenol if you have a normal liver is 3500-4000 mg. If your narcotic pain medicine is not lasting long enough you can use a little more or use if less often as long as you do not overuse the maximum daily acetaminophen dose.
Incision care
The surgery itself involves reopening the original incision from implantation and removing any scar tissue that has formed over the hardware. After removal or replacement of the hardware, the surgeon recloses the wound. If you had stitches, your doctor will tell you when to come back to have them removed. If you have skin glue on the cut (incision), leave it on until it falls off. Skin glue is also called liquid stitches.
If you do not have a cast, clean the incision twice a day after your doctor allows you to remove the bandage. Use only soap and water to clean the incision unless your doctor gives you different instructions. Don’t use hydrogen peroxide or alcohol. They can slow healing.
Exercise
Do any exercises given to you by your doctor or physical therapist. These exercises will help keep your muscles strong and your joints flexible while your bone heals. Wiggle your fingers or toes on the injured arm or leg often. This helps reduce swelling and stiffness.
Hygiene
Do not shower for 1 or 2 days after surgery. When you shower, keep your dressing and incisions dry. If you have a cast, tape a sheet of plastic to cover it so that it doesn’t get wet. Do not take a bath, swim, use a hot tub, or soak the affected area until any stitches are out and your incision is healed. This usually takes 1 to 2 weeks.
A Word From Ventura Orthopedic Today
The ability to help people to heal from orthopedic injuries by using various medical implants has offered many benefits. Sometimes, though, people report pain and irritation at the site of the implant. They may feel a grinding in their joint or irritation where the implant rubs below the skin. In these cases, it may be better to remove implants even though they were meant to stay in place. Removal itself requires more surgery and comes with its own risks, including infection. It’s also an option that doesn’t always work. Your healthcare provider will need to assess whether an implant removal is likely to succeed.
The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. We are committed to helping you through any procedure until optimum health, strength and mobility are restored. Call us today at 800-698-1280 to schedule an appointment.
