Related Experiment Video
Updated: Feb 25, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Association of Preoperative Anterior Ankle Soft Tissue Thickness and Infection After Primary Total Ankle
Vivek Nair1, Dylan Moran2, Matthew Cederman2
1Department of Orthopaedic Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.
Background:
TAA has gained wide acceptance and is a commonly performed surgery. In spite of this rise in popularity, both deep and superficial postoperative infections remain a significant issue following procedures performed through an anterior approach. Our study sought to identify whether a relationship exists between the thickness of the anterior ankle soft tissues and infection rates after TAA.
Methods:
We performed a retrospective cohort study of 293 patients who underwent primary TAA from 2017 to 2023 at a single institution. All patients had a preoperative computed tomography (CT) scan that was used for patient-specific instrumentation (PSI). All measurements of the anterior soft tissue envelope were obtained from CT scans. All procedures were done through an anterior approach. Patient demographics including body mass index (BMI) and diabetic status were recorded. A logistic regression analysis was performed to identify significant risk factors for postoperative infection after TAA.
Results:
Increasing anterior ankle soft tissue thickness was found to be significantly associated with postoperative infection after TAA (OR 1.31, 95% CI 1.17, 1.46, P < .001). This was also true of diabetic status (OR 4.9, 95% CI 1.70, 14.4, P = .003). When stratifying for deep and superficial infections, the relationship of ankle soft tissue thickness and infection remained significant for superficial infection (OR 1.26, 95% CI 1.13, 1.40, P = .013), but not for deep infection (P = .056). The mean age of our cohort was 68.2 years at the time of surgery (SD 8.6 years). Median follow-up was 16 months. Half (50.2%) of the patients were female; 9.6% were diabetic. Mean BMI was 30.3 (SD 5.3). Average anterior ankle soft tissue thickness was 16.5 mm (SD 4.0 mm).
Conclusion:
Our study demonstrates that a thicker anterior ankle soft tissue envelope was found to be significantly associated with superficial infection risk after TAA. This risk was independent of patient BMI, nor did BMI correlate with ankle soft tissue thickness (R 2 = 0.03). Our study may help inform perioperative care and counseling after this increasingly common procedure.
Level Of Evidence:
Level III, retrospective cohort study.
More Related Videos
06:28Anterior Cruciate Ligament Transection and Synovial Fluid Lavage in a Rodent Model to Study Joint Inflammation and Posttraumatic Osteoarthritis
Published on: September 2, 2025
07:24Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
