D'Errico M, Morelli I, Castellini G, Gianola S, Logoluso N, Romanò D, Scarponi S, Pellegrini A. Is debridement really the best we can do for periprosthetic joint infections following total ankle replacements? A systematic review and meta-analysis.
Foot Ankle Surg 2022;
28:697-708. [PMID:
34688527 DOI:
10.1016/j.fas.2021.10.008]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/22/2021] [Accepted: 10/06/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND
Ankle periprosthetic joint infections are rising in number, but an evidence-based gold standard treatment has not been defined yet.
METHODS
We made a systematic review about the operative treatment of infections following total ankle arthroplasty. Proportional meta-analysis was used to summarize effects of the surgical techniques included. Primary outcome of this study was infection eradication, followed by complications, re-interventions, amputation rates and functions.
RESULTS
We included six studies(113 patients) reporting 6 types of surgical interventions, mostly irrigation and debridement (35.4%) and two-stage revisions (24.8%). No differences among all analyzed techniques were found in the infection eradication outcome as well as in the secondary outcomes. Patients receiving a permanent spacer are most likely to end up with amputation.
CONCLUSIONS
Literature dealing with infections after total ankle replacement is currently composed by few low-quality articles. The overlapping of confidence intervals related to all analyzed interventions showed no superiority of either technique.
LEVEL OF EVIDENCE
III.
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