Metallic implant removal in children

Area of Science:

• Pediatric Orthopedics
• Biomaterials Science
• Surgical Practice

Background:

• Metallic implants are frequently used in pediatric orthopedic surgery.
• The decision-making process for removing these implants is complex and has evolved.
• Current literature and training curricula inadequately address metallic implant removal in children.

Purpose of the Study:

• To review the historical changes in indications for metallic implant removal in pediatric patients.
• To present the arguments for and against the routine removal of pediatric metallic implants.
• To delineate specific clinical situations where implant removal is indicated versus contraindicated.

Main Methods:

• Literature review of historical and current practices regarding pediatric metallic implant removal.
• Analysis of clinical decision-making factors influencing implant retention or removal.
• Synthesis of evidence to support recommendations for appropriate removal scenarios.

Main Results:

• Indications and practices for metallic implant removal have undergone substantial changes over the past century.
• The topic is infrequently covered in scientific publications, presentations, and residency training.
• Residents often gain knowledge of this subject sporadically through clinical experience.

Conclusions:

• A comprehensive understanding of the evolving indications for pediatric metallic implant removal is crucial.
• Clear guidelines are needed to assist clinicians in determining appropriate scenarios for implant removal.
• Further discussion and education on this topic are warranted within the pediatric orthopedic community.