Bone Implant Satisfaction Survey

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Do you have a moment to share some feelings about your implant? This six question
survey is designed to measure your true satisfaction with your bone implant. Feel free to
forward this important survey to anyone you know who has received an implant to fix a bone
fracture.

What kind of implant do you have? (Check all that apply to you)

Bone Screw

Pin or Rod

Hip Implant

Knee Implant

Wire

Plate

Other:

Why did you get a bone implant?

Injury

Bone deformity

Infection

Cancer

Other:

Did your implant solve the problem?

Yes

Other:

Clear selection

If no, was the implant removed?

Yes

N/A

Other:

Clear selection

If the implant was removed, why? (Check all that apply)

N/A

Medical failure

Implant didn't work

Infection

Healing problem

Pain or irritation

Other:

What qualities would you want in a bone implant (Check all that apply)

Does not require an invasive surgery

Prevents infection

Will not interfere with MRI or metal detector

Can be safely removed using keyhole surgery

Reduced post-operative care

Provide strength similar to normal bone

Other:

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