Implant Failure Rates and Risk Factors: Retrospective Observational Study

Abstract

Background: Implant failure remains a significant concern in orthopedic surgeries, particularly in fracture fixation and arthroplasty procedures. Understanding failure rates and associated risk factors can guide surgical planning and implant selection. Methods: We conducted a retrospective observational study of 312 patients who underwent internal fixation or joint replacement between January 2019 and December 2023 at a tertiary care center. Implant failure was defined as breakage, loosening, cut-out, mechanical migration, or revision surgery within 24 months of index surgery. Demographic data, fracture pattern, comorbidities, surgical technique, bone quality, and implant type were analyzed. Failure rates were calculated, and logistic regression identified independent risk factors. Results: Implant failure occurred in 28 patients (9%). Higher failure rates were observed in unstable fracture patterns (15%), osteoporotic bone (18%), and patients with delayed weight-bearing (>12 weeks, 12%). Multivariate analysis revealed osteoporosis (OR 3.1, p = 0.004), inadequate reduction (OR 2.7, p = 0.01), infection (OR 4.2, p = 0.002), and smoking (OR 2.2, p = 0.03) as independent predictors of implant failure. Conclusion: Implant failure is strongly associated with poor bone quality, technical factors, and infection. Optimising surgical reduction, infection control, and early mobilisation, particularly in osteoporotic patients, may reduce the risk of failure.