Complications Common After Ankle Replacement

Thromboembolic complications and deep vein thrombosis are as common in patients who have total ankle replacements as they are in those who undergo hip or knee replacement. That is the result of a study presented at the American Orthopaedic Foot and Ankle Society Annual Meeting.

“The incidence of thromboembolic complications after total ankle replacement is between 0 and almost 10%, ” said Alexej Barg, M.D., study author. “In our patient cohort, the incidence was almost 3.5%, which is comparable to data observed in patients undergoing the replacement of a hip or knee joint.”

Barg and the researchers at Kantonsspital Liestal in Switzerland conducted a systematic review of the literature and extracted information on 964 total ankle replacements performed between 2000 and 2009 at 28 different clinics. The majority of studies included were level IV. Barg said there is limited literature on the incidence of thromboembolic prophylaxis after total ankle replacement (TAR).

They found a range of 0% to 10% of patients had thromboembolic complications after TAR and 3.5% of patients had symptomatic deep vein thrombosis following TAR. Twenty of 28 studies described low molecular weight heparin as the method of prophylaxis given to patients for six weeks postoperatively. “We suggest prophylaxis using low molecular weight heparin in patients with known risk factors, ” Barg said.