This article is more than 5 years old. Information may no longer be current.
Unclear whether diabetes impacts outcomes after ankle arthrodesis
Wukich DK. J Foot Ankle Surg. Published online March 10, 2011.
Click Here to Manage Email Alerts
Investigators of this study could not determine if patients with diabetes who underwent retrograde ankle arthrodesis using intramedullary nails had significantly lower clinical outcomes compared with patients without diabetes.
“A study of 100 patients in each group would be necessary to achieve adequate power to conclusively state that diabetes mellitus had no impact on the final outcome,” the authors wrote.
Dane K. Wukich, MD, and colleagues at the University of Pittsburgh School of Medicine, retrospectively followed 40 consecutive patients who had a minimum follow-up of 1 year. The trial included 17 patients with diabetes and 23 who did not have the disease.
The results showed that the mean AOFAS hindfoot score improved significantly from 19 points to 55 points. On average, patients with diabetes improved from 24 points to 55 points, and patients without diabetes improved from 16 points to 55 points. In all, 59% of patients with diabetes and 44% without the disease had postoperative complications; however, this difference did not reach statistical significance. Patients with diabetes used a brace more often. Patients with a history of preoperative skin ulcers had higher rates of infection.
The investigators did not find any significant postoperative differences in AOFAS hindfoot scores between patients with diabetes compared with those who did not have diabetes. Patients with diabetes had an average improvement of 129%; patients without the disease improved 243%.
With the numbers available, the investigators could not confirm their hypothesis that patients with diabetes and neuropathy would have inferior outcomes, and more postoperative complications than patients who did not have diabetes.