Association of Preoperative Anterior Ankle Soft Tissue Thickness and Infection After Primary Total Ankle Arthroplasty: A Retrospective Cohort Study.

Background: TAA has gained wide acceptance and is a commonly performed surgery. In spite of this rise in popularity, both deep and superficial postoperative infections remain a significant issue following procedures performed through an anterior approach. Our study sought to identify whether a relationship exists between the thickness of the anterior ankle soft tissues and infection rates after TAA. Methods: We performed a retrospective cohort study of 293 patients who underwent primary TAA from 2017 to 2023 at a single institution. All patients had a preoperative computed tomography (CT) scan that was used for patient-specific instrumentation (PSI). All measurements of the anterior soft tissue envelope were obtained from CT scans. All procedures were done through an anterior approach. Patient demographics including body mass index (BMI) and diabetic status were recorded. A logistic regression analysis was performed to identify significant risk factors for postoperative infection after TAA. Results: Increasing anterior ankle soft tissue thickness was found to be significantly associated with postoperative infection after TAA (OR 1.31, 95% CI 1.17, 1.46, Conclusion: Our study demonstrates that a thicker anterior ankle soft tissue envelope was found to be significantly associated with superficial infection risk after TAA. This risk was independent of patient BMI, nor did BMI correlate with ankle soft tissue thickness ( Level of Evidence: Level III, retrospective cohort study.