Insight on Infections Following Total Anke Arthroplasty

Demand has continued to increase for Total Ankle Arthroplasty (TAA) among patients and surgeons alike, as the popularity and indications have continued to expand. However, treatment for infections, albeit rare, remain without consensus. And overlap in the presentation between aseptic loosening and deep infection may present a diagnostic and treatment dilemma for surgeons.

The definition of periprosthetic infection currently varies between the Musculoskeletal Infection Society (MSIS), Infectious Disease Society of America (IDSA), and International Consensus Group on Periprosthetic Joint Infections. The most accepted definition is extrapolated from the MSIS criteria following hip and knee arthroplasty.

In their recent study, "Time to Revision After Periprosthetic Joint Infection in Total Ankle Arthroplasty: A Systematic Review," Dr. Miner et al. offer the first systematic review investigating the temporal relationship infection following TAA and TAA revision.

The review provides the following key insights, and proposes a new criteria for acute (<13.5 months postop) versus chronic (>13.5 months postop) infections after TAA.

• Periprosthetic infection prevalence after TAA was 1.12%

• 91% of cases were chronic infections

• Mean time to infection was 2.6 years after the procedure

• Persistent pain was the most common presenting symptom, without obvious etiology

• Only one case required below the knee amputation for definitive treatment

Download the full article from the Journal of Foot & Ankle Surgery at https://www.jfas.org/.