Malnutrition is associated with poor outcomes following total ankle arthroplasty.

BACKGROUND: Malnutrition has been associated with various complications following orthopaedic surgery. This study evaluated the effects of malnutrition on outcomes following total ankle arthroplasty (TAA).

METHODS: A retrospective review yielded 1542 propensity matched TAA patients. The malnutrition cohort consisted of patients with laboratory evidence of transferrin ≤ 204 mg/dL, leukocyte ≤ 1.5 × 10 ³ /µL, or albumin ≤ 3.5 g/dL within 3 months prior to surgery. Short-term medical complications and long-term mechanical outcomes were evaluated.

RESULTS: Within 90 days postoperatively, malnutrition was associated with a significant risk of readmission, wound disruption, sepsis, myocardial infarction, pulmonary embolism, pneumonia, deep vein thrombosis, and infection (p < 0.05). At 5 years, malnutrition was associated with a periprosthetic joint infection, revision arthrodesis, periprosthetic fracture, and below knee amputation (p < 0.05).

CONCLUSIONS: Adequate preoperative transferrin, albumin, and leukocyte values is a potential modifiable factor to prevent poorer outcomes following TAA.

LEVEL OF EVIDENCE: III.