Greater soft tissue thickness may be associated with revision total ankle arthroplasty
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Key takeaways:
- BMI did not differ between patients who did and did not undergo revision total ankle arthroplasty.
- Radiographs showed patients who underwent revision total ankle arthroplasty had greater soft tissue thickness.
Radiographic measurements showed greater soft tissue thickness at the tibial and talar regions of the ankle was associated with the need for revision total ankle arthroplasty, according to presented results.
Researchers also found these radiographic measurements were more effective predictors of revision surgery compared with BMI.
“Further research is needed to further validate our findings, but this would serve as a cost-effective risk stratification measure preoperatively for patients undergoing revision total ankle arthroplasty,” Alexandra Krez, BA, an MD candidate at Duke University School of Medicine, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Krez and colleagues retrospectively reviewed data for 323 patients who underwent primary total ankle arthroplasty between 2003 and 2019. Researchers defined the primary outcome as the need for revision total ankle arthroplasty.
“We defined and assessed two radiographic measurements: tibial tissue thickness and talar tissue thickness,” Krez said. “The tibial tissue thickness was established by creating a template at the most distal aspect of the tibia, extending from the anterior cortex to the posterior cortex. The distance between the anterior cortex to the soft tissue shadow is what we defined as the tibial tissue thickness.”
According to Krez, talar tissue thickness was defined as “the extending line from the lateral process to the talar head-neck junction ... to the soft tissue shadow.”
At a 5-year minimum follow-up, Krez said 14 patients (4.3%) required revision total ankle arthroplasty. Patient demographics, age, diabetes, smoking status, implant design and BMI did not differ between patients who did and those who did not undergo revision, according to Krez.
“The BMI in the revision group was 29.7 kg/m2 and in the people that did not undergo revision was 29.6 kg/m2,” she said.
Krez said preoperative radiographs showed patients who underwent revision total ankle arthroplasty had a greater tibial and talar thickness.
“Further, undergoing multivariable analysis, it still held that tibial and talar tissue thickness remained significant predictors of revision total ankle arthroplasty,” Krez said.
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Wu K, et al. Association of radiographic soft tissue thickness with revision total ankle arthroplasty following primary total ankle arthroplasty: A minimum of 5-year follow-up. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 11-14, 2024; Vancouver, British Columbia, Canada (hybrid meeting).
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