Previous Surgery and the Temporal Evolution of Functional Outcomes and Complication Rates in Total Ankle Replacement

Given that most ankle replacements are post-traumatic in origin, it is important to investigate if prior interventions affect a patient's functional outcomes or increase the possibility of complications. Prior ankle surgeries create scar tissue and zones of impaired vascularity which could ultimately interfere with surgical healing. The purpose of this study is to assess the pain and functional temporal outcomes of patients with and without prior surgeries in the ipsilateral ankle. We retrospectively identified a consecutive series of 100 primary total ankle replacements (TARs) who were followed for a minimum of 3 years, with follow-up time points of 0, 6, 12, and 36 months. We documented prior surgical interventions and several patient-reported outcomes. Outcomes were measured using American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analogue Scale (VAS), 12-Item Short Form Study (SF-12), and range of motion scores. The 2 groups showed no difference on the temporal evolution of outcomes. An irrigation and debridement of previous open fractures was the only presurgical intervention that showed a statistically significant difference in temporal evolution of functional and pain outcomes between intervention and nonintervention groups. No significant correlations were found between all outcomes and the time between the last intervention and ankle replacement surgery. A preoperative discussion should center on potential complications and predicted functional outcomes. The presence, type, and timing of an intervention prior to an ankle replacement do not strongly affect the temporal outcomes of pain and functional outcome scores. Furthermore, the complication rate is not affected by prior surgeries.