Neurological injury rate of 16% reported with total ankle arthroplasty

Issue: March 2017

SAN DIEGO — Results of a retrospective study of total ankle arthroplasty in 145 patients with primary or end-stage osteoarthritis showed a 16% rate of neurological injury.

This injury was associated with reduced patient satisfaction and poorer clinical outcomes using the American Orthopaedic Foot and Ankle Society score compared to patients who underwent total ankle arthroplasty (TAA) but did not sustain such an injury, according to Min-Cheol Kim, MD, of Gwangju, Republic of Korea.

Min-Cheol Kim

At the American Academy of Orthopaedic Surgeons Annual Meeting, here, Kim noted the patients all underwent TAA with the Hintegra Total Ankle Prosthesis (Integra Lifesciences) between 2005 and 2011. They were followed for a mean of 41.3 months and there were a total of 145 ankles.

“Neurological injury after total ankle arthroplasty [TAA] is considerable,” Kim said.

He noted there were 23 nerve injuries, which included nine posterior tibial nerve injuries and six injuries each of the superficial and the deep peroneal nerves. In addition, there was one injury each to the saphenous and sural nerves.

“The prevalence of neurological injury after ankle arthroplasty is reported to vary from 2.4% to 21%, which is known to be caused by various situations during surgery,” Kim said.

Based on the results, neurologic injury was significantly associated with the development of post-traumatic osteoarthritis. However, Kim and colleagues found no significant association between neurologic injury and what he described as potential predisposing factors to such an injury, such as age, gender, BMI and the duration of the patient’s symptoms preoperatively.

“All of the nerve injuries recovered completely or incompletely,” Kim said. – by Susan M. Rapp

Reference:

Kim M-C, et al. Paper #259. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 14-18, 2017; San Diego.