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RA May Raise Complication Risk After Ankle Arthroplasty

Those with inflammatory connective-tissue disease have 14-fold higher risk for additional surgery

MONDAY, Sept. 27 (HealthDay News) -- Underlying inflammatory connective-tissue disease, primarily rheumatoid arthritis, is associated with an increased risk for major incision complications and additional surgery for patients who have undergone total ankle arthroplasty, according to research published in the Sept. 15 issue of the Journal of Bone & Joint Surgery.

Steven M. Raikin, M.D., of the Thomas Jefferson University Hospital in Philadelphia, and colleagues reviewed the charts of 106 patients who had total ankle arthroplasty, and assembled data on potential risk variables, including age, sex, body mass index, diabetes, smoking, medications, diagnosis, implant size, tourniquet time, closure method, and anticoagulation status. They noted the incidence of wound-related complications and categorized outcomes: no complications (uncomplicated wound healing), minor complications (local care or oral antibiotics needed), and major complications (surgical intervention required).

The researchers found that, in the comparison of patients who had no or only minor wound complications to patients who had major wound complications, female sex, a history of corticosteroid use, and underlying inflammatory arthritis were associated with higher risk. Among those needing additional surgery for major complications, underlying inflammatory connective-tissue disease (primarily rheumatoid arthritis) was the only significant risk factor, incurring a 14-fold risk after adjustment for potential confounders. Patients with a history of diabetes had significantly increased risk of minor complications.

"We recommend that caution be used when selecting and educating patients with inflammatory arthritic conditions who are potential candidates for total ankle arthroplasty," the authors write.

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