CME OnDemand: 2022 AOFAS Annual Meeting-90-Day Reoperation and Wound Complication Rates in Lateral Approach to Total Ankle Replacement for Post-Traumatic Arthritis

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This study examined the demographics and early clinical complications of patients who underwent Zimmer TAR (Total Ankle Replacement) for post-traumatic osteoarthritis. The study included 49 patients with an average age of 60.71 years and an average BMI of 34.25. Among the patients, 22 were female and 27 were male. Six patients were current smokers, eight were past smokers, and one had secondhand smoking-related COPD. Eleven patients had diabetes, with an average HbA1c of 6.94. Other comorbidities included hypertension (32 patients), heart disease (6 patients), and thyroid disorder (8 patients).<br /><br />The post-operative complications observed within three months of surgery included infection, pain from hardware, tibial nerve complications, and poor healing of the fibula. Revision surgeries were performed, including hardware removal, tarsal tunnel decompression, and irrigation and debridement.<br /><br />The study found a similar rate of early re-operation following TAR in the lateral approach, with a rate of 6.1%. The rate of infection was slightly higher at 4.1%. Fibular non-union was not clinically observed.<br /><br />The study suggests further research to evaluate the early radiographic findings in Zimmer TAR and correlate them with ankle alignment and patient-reported outcomes. The limitations of the study include the small sample size of 49 patients and the fact that all surgeries were performed within one health system.<br /><br />The study references previous research on the systemic medical complications following total ankle arthroplasty, the impact of diabetes on TAR outcomes, complications rates and outcomes associated with tobacco use, and the risk factors and treatment options for infected total ankle arthroplasty. Other references include studies on the effects of tobacco use on incision healing in TAR, patient-related risk factors for periprosthetic ankle joint infection, and the clinical and radiographic outcomes of trabecular metal total ankle replacement using a transfibular approach.<br /><br />The study acknowledges the guidance and expertise of Dr. Michael C. Aynardi and the assistance of the Center for Orthopaedic Research and Translational Science (CORTS).

Asset Subtitle

Jacob R. Staub, Kristen Manto, PhD, James Mellen, Zackary Koroneous, BD, Michael C. Aynardi, MD

Keywords

Zimmer TAR

post-traumatic osteoarthritis

patient demographics

clinical complications

infection

revision surgeries

ankle alignment

patient-reported outcomes

diabetes impact

tobacco use outcomes