Orthopaedic implant retrieval: An interdisciplinary approach

The evaluation of retrieved orthopaedic implants, removed at revision surgery or autopsy, contributes to our understanding of how implants behave in situ as well as how the human body responds to the implant and its biomaterials. Establishing an orthopaedic implant retrieval program requires knowledge of regulatory issues (IRB review, e.g.), personnel, equipment (saw, disposables, etc.), and financing. Maximizing the information that can be acquired from each explant is dependent upon adequate preparation including determining what questions are to be addressed, establishing standard operating procedures, and deciding which analyses will be performed. Analyses may include photographic, radiographic, biomechanical, histologic, and various spectroscopy techniques. The decision as to which analysis or analyses will be performed dictates how best to handle and process the retrieved specimens. There are many steps in the process of a successful implant retrieval beginning with approaching the patient and/or family of the patient until the final interpretation of the data. Having an informed and educated team (including the office staff) is vital to implementation of the program. Acquiring the proper documentation, a retrieval kit, and supplies for the initial processing prior to the retrieval procedure increases the efficiency and effectiveness of the process. Radiographs, photographs, and thorough documentation throughout the processing of the specimens adds significantly to the information that can be realized. In conclusion, appreciating the uniqueness and value of each patient and each retrieved implant will ultimately lead to invaluable information concerning orthopaedic implants.