Related Experiment Video
Updated: Jan 8, 2026
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
12.2K
Preoperative SSRI Use and Complications After Ankle and Hindfoot Open Reduction Internal Fixation: A
Andrew White1, Myra Chao1, Hana Hashioka1
1Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA.
Foot & Ankle International
|December 20, 2025
Summary
Selective serotonin reuptake inhibitor (SSRI) use before ankle and hindfoot surgery increases the risk of medical and surgical complications. Patients taking SSRIs experienced higher rates of readmission, kidney failure, and wound complications post-operation.
Area of Science:
- Orthopedic surgery
- Pharmacology
- Patient outcomes
Background:
- Selective serotonin reuptuptake inhibitors (SSRIs) are widely prescribed for depression and anxiety.
- Emerging evidence suggests SSRIs may negatively impact bone health and fracture healing.
- The effect of SSRIs on outcomes following ankle and hindfoot open reduction and internal fixation (ORIF) remains unclear.
Purpose of the Study:
- To investigate the association between preoperative SSRI use and complications after ankle and hindfoot ORIF.
- To evaluate the impact of SSRIs on both medical and surgical outcomes in this patient population.
Main Methods:
- Retrospective review of the TriNetX database (2005-2023) including patients undergoing ORIF for ankle, talus, calcaneus, or pilon fractures.
- Two propensity score-matched cohorts (1:1) were created: patients with active SSRI prescriptions (≥3 months pre-op) and controls without SSRI use.
- Analysis included 12,612 patients per group, matched for demographics, comorbidities, procedure type, and open fracture status.
Main Results:
- At 6 months post-surgery, SSRI use was linked to significantly higher risks of readmission, acute kidney failure, emergency department visits, pulmonary embolism, and urinary tract infections.
- Conversely, SSRI use was associated with a decreased risk of sepsis.
- At 2 years, SSRI use correlated with increased risks of wound dehiscence, implant-related pain, and conversion to ankle fusion.
Conclusions:
- Preoperative SSRI use is associated with a significant increase in medical and surgical complications following ankle and hindfoot ORIF.
- These findings highlight the need for further research into the underlying mechanisms.
- Perioperative counseling regarding these risks is recommended for patients on SSRIs undergoing these procedures.
