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Management of the Infected Total Ankle Replacement

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Abstract

Infections following total ankle replacement are a serious complication, about which there is little information in the current literature to guide diagnosis and treatment. Infections are classified as acute postoperative, late chronic, or remote hematogenous. Prosthesis removal for infection following primary or revision total ankle replacement along with a thorough debridement and parenteral culture-driven antibiotic therapy are the mainstay of treatment. Only a limited number of patients who develop a deep periprosthetic infection following primary or revision total ankle replacement can expect to undergo successful joint-preserving revision total ankle replacement. Instead, ankle or tibio-talo-calcaneal arthrodesis usually with significant volumes of bone graft is required to obtain a functional limb. Given the morbidity of infected total ankle replacement, careful consideration should be made about performing these procedures in patients with multiple prior surgeries and comorbidities that predispose to wound healing difficulties. Prompt diagnosis and involvement of a multidisciplinary care team is essential to a successful outcome.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Marshfield Clinic, 1000 North Oak Ave, Marshfield, WI, 54449, USA

    Christopher Bibbo DO, DPM, FACS

  2. Division of Plastic Surgery, Department of Orthopaedic Surgery, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, South Pavilion, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Steven J. Kovach MD

Authors
  1. Christopher Bibbo DO, DPM, FACS
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  2. Steven J. Kovach MD
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Corresponding author

Correspondence to Christopher Bibbo DO, DPM, FACS .

Editor information

Editors and Affiliations

  1. Gundersen Health System, La Crosse, Wisconsin, USA

    Thomas S. Roukis

  2. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Gregory C. Berlet

  3. Wisconsin Foot and Ankle Institute, Marshfield, Wisconsin, USA

    Christopher Bibbo

  4. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Christopher F. Hyer

  5. Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada

    Murray J. Penner

  6. Foot and Ankle Center Karlsruhe, Karlsruhe, Germany

    Markus Wünschel

  7. Atlantic Foot & Ankle Center of Chesapeake, Chesapeake, Virginia, USA

    Mark A. Prissel

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© 2016 Springer International Publishing Switzerland

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Bibbo, C., Kovach, S.J. (2016). Management of the Infected Total Ankle Replacement. In: Roukis, T., et al. Primary and Revision Total Ankle Replacement. Springer, Cham. https://doi.org/10.1007/978-3-319-24415-0_25

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  • DOI: https://doi.org/10.1007/978-3-319-24415-0_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24413-6

  • Online ISBN: 978-3-319-24415-0

  • eBook Packages: MedicineMedicine (R0)

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