Evaluating Total Ankle Arthroplasty Candidates and Risks

September 20, 2010

Take caution when selecting total ankle arthroplasty candidates.

Researchers from Thomas Jefferson University Medical College recommend that caution be taken when selecting and educating patients with arthritic conditions about total ankle arthroplasty.

The team performed a retrospective chart review of 106 total ankle arthroplasties and published their findings in the The Journal of Bone and Joint Surgery (American).

The team sought to evaluate previous data from surgeries to evaluate the possible risk factors for developing wound complications. They examined independent risk variables, including: age, sex, body-mass index, diabetes, smoking, medications, preoperative diagnosis, implant size, tourniquet time, closure method, and anticoagulation status.

Post-operative notes were also examined. The outcomes were divided into three categories: no complications, minor complications, and major complications.

The team found that when patients with no complications were compared with those who had minor complications, a history of diabetes was the only variable identified as resulting in a significant increase. Next, they compared patients with no complications or minor wound complications to those with major complications. They found that the female sex, a history of corticoid steroid use, and underlying inflammatory arthritis were all associated with increased risk.

Additionally, the researchers found that underlying inflammatory arthritis was the only significant risk factor for major wound complications.