ABSTRACT
While not a common complication after total ankle arthroplasty (TAA), periprosthetic
joint infection (PJI) presents a significant risk of implant failure. The primary
aim of this systematic review was to evaluate time to revision after PJI in patients
who had undergone TAA. An extensive search strategy via electronic databases initially
captured 11,608 citations that were evaluated for relevance. Ultimately, 12 unique
articles studying 3040 implants met inclusion criteria. The time to revision surgery
due to PJI was recorded for each study and a weighted average obtained. The prevalence
of PJI was 1.12% (n = 34). We found that the average time to revision due to PJI was
30.7 months, or approximately 2.6 years after the index TAA procedure. By literature
definitions, the majority of cases (91.2%, n = 31) were beyond the “acute” PJI phase.
The population was divided into 2 groups for further analysis of chronic infections.
PJIs before the median were classified as “early” and those after as “late” chronic.
The majority of cases (61.8%) were late chronic with an average time to revision of
44.3 months. A smaller number were early chronic (29.4%) with revision within 10.8
months. After summarizing the rates of infection and times to revision reported in
the literature, we suggest modifying the current PJI classification to include early
chronic and late chronic subgroups so that the total ankle surgeon is better prepared
to prudently diagnose and treat PJIs.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 12, 2022
Footnotes
Financial Disclosure: The authors received no financial support for this research.
Conflict of Interest: The authors have no conflicts of interest to disclose.
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