Table 3

Variables contributing to the likelihood of agreement in the different statements about general attitudes towards implant removal.

Statement

Surgeons' age

Male versus female surgeon

Orthopedic versus non-orthopedic surgeon

European versus US-American origin

European versus non-European origin

University versus other affiliation


Orthopedic implants must be removed in younger patients (<40 years of age), even if they cause no problems

1.03 (1.01–1.04)

1.12 (0.74–1.70)

1.23 (0.92–1.64)

7.40 (3.77–14.50)

1.56 (1.12–2.18)

0.72 (0.54–0.97)

Leaving implants in-situ poses a risk for later fractures

0.99 (0.98–1.01)

1.32 (0.86–2.02)

1.13 (0.84–1.50)

2.81 (1.44–5.47)

0.98 (0.71–1.35)

0.79 (0.59–1.06)

Titanium implants are safer to be kept in-situ than devices made from stainless steel

1.02 (1.00–1.04)

0.82 (0.54–1.22)

0.72 (0.54–0.96)

2.16 (1.18–3.97)

1.05 (0.76–1.45)

1.04 (0.78–1.38)

In case of otherwise unexplained pain and functional deficits, implant removal is a good option to improve the physical status

1.00 (0.98–1.02)

0.86 (0.53–1.38)

0.73 (0.54–1.00)

2.74 (1.47–5.11)

1.81 (1.28–2.55)

0.83 (0.61–1.13)

Leaving implants in-situ increases the life-time risk for chronic infections, allergy, and cancer

1.01 (0.99–1.03)

1.14 (0.74–1.76)

1.26 (0.94–1.68)

1.66 (0.90–3.08)

0.99 (0.72–1.37)

0.92 (0.69–1.22)

Removing implants is a surgical procedure which drains valuable hospital resources

1.00 (0.98–1.02)

1.51 (0.91–2.48)

0.99 (0.72–1.38)

1.39 (0.68–2.84)

1.11 (0.77–1.60)

1.08 (0.78–1.50)

Removing implants damages healed soft tissue, and is riskier than retaining the device

0.99 (0.97–1.00)

1.06 (0.69–1.64)

0.91 (0.68–1.22)

1.20 (0.65–2.23)

1.20 (0.65–2.23)

1.36 (1.01–1.82)

Given the time and efforts required for implant removal, this procedure is not adequately reimbursed by insurance companies

1.02 (1.00–1.03)

1.41 (0.93–2.14)

1.43 (1.07–1.91)

0.37 (0.19–0.70)

0.37 (0.19–0.70)

1.25 (0.93–1.67)

Patients should take responsibility for the incurring costs of implant removal

1.03 (1.01–1.05)

2.39 (1.52–3.76)

1.61 (1.20–2.16)

0.48 (0.26–0.91)

0.24 (0.17–0.34)

1.31 (0.98–1.75)


Numbers are odds ratios derived from ordered logistic regression, with 95% confidence intervals in parentheses. Values >1 indicate a higher likelihood of agreement, and values <1 indicate a higher likelihood in disagreement. If the 95% confidence limits exclude 1, statistically significant results can be assumed at the two-tailed 5% threshold.

Hanson et al. BMC Musculoskeletal Disorders 2008 9:73   doi:10.1186/1471-2474-9-73

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