Diabetes may contribute to increased complications after total ankle arthroplasty
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Key takeaways:
- Results showed patients with diabetes had a 363% increased risk for septic revision.
- Patients with diabetes also had a 95% increased risk for periprosthetic joint infection.
LOUISVILLE, Ky. — Data presented here showed diabetes may contribute to increased postoperative complications following total ankle arthroplasty.
“Based on our data, this evidence supports previous smaller studies demonstrating diabetes as an independent contributor to postoperative complications,” Jordan A. Helbing, BS, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Helbing and colleagues retrospectively analyzed data from the PearlDiver Patient Records Database of 8,317 patients (345 with concurrent diabetes) who had undergone total ankle arthroplasty to determine whether diabetes impacts the risks for 90-day and 5-year postoperative complications.
Helbing said patients with diabetes had an increased risk for stroke at 90-day follow-up.
“But, interestingly enough, surgical site infections, arrhythmia with atrial fibrillation, pneumonia and [urinary tract infection] UTI were not statistically significant following multivariate analysis,” Helbing said.
Researchers found a 363% increased risk for septic revision and a 95% increased risk for periprosthetic joint infection at 5-year follow-up among patients with diabetes. Helbing said patients with diabetes had a cumulative incidence rate for septic revision of 1.4% vs. 0.4% among patients without diabetes. Patients with diabetes also had a cumulative incidence rate for PJI of 7.3% compared with 3.9% among patients without diabetes, according to Helbing.
“In the future, we recommend total ankle arthroplasty registries collect preoperative and longitudinal postoperative hemoglobin A1c levels to gain a better understanding of the factors impacting infection risk, and which diabetic patients are at the highest risk,” Helbing said.
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Helbing J, et al. The effect of diabetes mellitus on total ankle arthroplasty outcomes. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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