Diabetes Increases Risk of Infection After Ankle Replacement Surgery, Study Finds
Patients with diabetes undergoing total ankle arthroplasty (TAA) face a significantly higher risk of postoperative infections compared to those without the condition, according to a new study. The study results were published in the journal Foot Ankle International.
The research, drawing on data from over 8,000 patients, highlights the increased challenges diabetic patients may encounter following ankle replacement surgery. Postoperative infections, aseptic loosening, and other perioperative medical complications present significant challenges following total ankle arthroplasty (TAA). Total ankle arthroplasty is performed to relieve pain and restore function in patients with ankle arthritis. While the procedure is generally effective, it comes with risks such as infections and the loosening of the artificial joint over time. Previous studies have indicated that diabetes could increase the likelihood of surgical complications, but the extent of its impact on ankle surgeries was not fully understood until now.
The study utilized a large insurance database to identify patients who underwent TAA between 2010 and 2021. Researchers focused on comparing the postoperative outcomes between patients diagnosed with diabetes and those without. Specifically, they examined the incidence of all-cause revision, periprosthetic joint infection (PJI), septic revision (where the joint must be surgically cleaned or replaced due to infection), and aseptic revision (surgery not related to infection).
Results revealed that within five years of undergoing TAA, 7.3% of diabetic patients were diagnosed with a periprosthetic joint infection, compared to just 3.9% of non-diabetic patients. This marked a 95% increased risk of infection for those with diabetes. Furthermore, the incidence of septic revision was 1.4% in diabetic patients, significantly higher than the 0.4% observed in non-diabetics, translating to a 363% increased risk. Interestingly, the study found no significant difference in the overall rate of joint revisions between the two groups, suggesting that while diabetes increases the risk of specific serious complications like infections, it does not affect the broader likelihood of needing a joint revision for other reasons.
These findings underscore the importance of targeted perioperative management for diabetic patients undergoing ankle replacement surgery. Tailored strategies could help mitigate the increased risk of infection and improve outcomes for this vulnerable group.This comprehensive analysis not only confirms diabetes as a significant risk factor for postoperative complications in ankle replacement but also calls for further research to develop effective preventive measures. As the diabetic population continues to grow, understanding and addressing these risks becomes increasingly crucial in orthopedic surgery.
Further reading: Helbing J, Farley B, Gu A, et al. Diabetes Mellitus and Total Ankle Arthroplasty Complications. Foot Ankle Int. Published online February 8, 2024. doi:10.1177/10711007241226929.
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