Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000070.xml
Semin Musculoskelet Radiol 2012; 16(03): 241-253
DOI: 10.1055/s-0032-1320124
DOI: 10.1055/s-0032-1320124
Postoperative Infection in the Foot and Ankle
Further Information
Publication History
Publication Date:
31 July 2012 (online)
Abstract
Our discussion highlights the commonly performed surgical procedures in the foot and ankle and reviews the various imaging modalities available for the detection of infection with graphic examples to better enable radiologists to approach the radiological evaluation of postoperative infection in the foot and ankle. Discrimination between infectious and noninfectious inflammation remains a diagnostic challenge usually needing a combination of clinical assessment, laboratory investigations, and imaging studies to increase diagnostic accuracy.
-
References
- 1 Kitaoka HB, Patzer GL. Clinical results of the Mayo total ankle arthroplasty. J Bone Joint Surg Am 1996; 78 (11) 1658-1664
- 2 Kitaoka HB, Patzer GL, Ilstrup DM, Wallrichs SL. Survivorship analysis of the Mayo total ankle arthroplasty. J Bone Joint Surg Am 1994; 76 (7) 974-979
- 3 Saltzman CL. Total ankle arthroplasty: state of the art. Instr Course Lect 1999; 48: 263-268
- 4 Hintermann B, Valderrabano V. Total ankle replacement. Foot Ankle Clin 2003; 8 (2) 375-405
- 5 Gill LH. Challenges in total ankle arthroplasty. Foot Ankle Int 2004; 25 (4) 195-207
- 6 Spirt AA, Assal M, Hansen Jr ST. Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am 2004; 86-A (6) 1172-1178
- 7 Easley ME, Vertullo CJ, Urban WC, Nunley JA. Total ankle arthroplasty. J Am Acad Orthop Surg 2002; 10 (3) 157-167
- 8 Stengel D, Bauwens K, Ekkernkamp A, Cramer J. Efficacy of total ankle replacement with meniscal-bearing devices: a systematic review and meta-analysis. Arch Orthop Trauma Surg 2005; 125 (2) 109-119
- 9 Murnaghan JM, Warnock DS, Henderson SA. Total ankle replacement. Early experiences with STAR prosthesis. Ulster Med J 2005; 74 (1) 9-13
- 10 Anderson T, Montgomery F, Carlsson A. Uncemented STAR total ankle prostheses. J Bone Joint Surg Am 2004; 86-A (Pt 2, Suppl 1) 103-111
- 11 Tarasevicius S, Tarasevicius R, Kalesinskas RJ, Janusonis V. Early results of total ankle arthroplasty [in Lithuanian]. Medicina (Kaunas) 2004; 40 (4) 327-331
- 12 Vickerstaff JA, Miles AW, Cunningham JL. A brief history of total ankle replacement and a review of the current status. Med Eng Phys 2007; 29 (10) 1056-1064
- 13 Deorio JK, Easley ME. Total ankle arthroplasty. Instr Course Lect 2008; 57: 383-413
- 14 Yalamanchili P, Neufeld S, Lin S. Total ankle arthroplasty: a modern perspective. Curr Orthop Pract 2009; 20 (2) 106-110
- 15 Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements?: a systematic review of the literature. Clin Orthop Relat Res 2010; 468 (1) 199-208
- 16 Cracchiolo III A, Deorio JK. Design features of current total ankle replacements: implants and instrumentation. J Am Acad Orthop Surg 2008; 16 (9) 530-540
- 17 Cracchiolo III A, Kitaoka HB, Leventen EO. Silicone implant arthroplasty for second metatarsophalangeal joint disorders with and without hallux valgus deformities. Foot Ankle 1988; 9 (1) 10-18
- 18 Cracchiolo III A, Weltmer Jr JB, Lian G, Dalseth T, Dorey F. Arthroplasty of the first metatarsophalangeal joint with a double-stem silicone implant. Results in patients who have degenerative joint disease failure of previous operations, or rheumatoid arthritis. J Bone Joint Surg Am 1992; 74 (4) 552-563
- 19 Knobloch K, Kraemer R, Lichtenberg A , et al. Achilles tendon and paratendon microcirculation in midportion and insertional tendinopathy in athletes. Am J Sports Med 2006; 34 (1) 92-97
- 20 Lindholm A. A new method of operation in subcutaneous rupture of the Achilles tendon. Acta Chir Scand 1959; 117: 261-270
- 21 Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am J Sports Med 1990; 18 (2) 188-195
- 22 FitzGibbons RE, Hefferon J, Hill J. Percutaneous Achilles tendon repair. Am J Sports Med 1993; 21 (5) 724-727
- 23 Bergin D, Morrison WB. Postoperative imaging of the ankle and foot. Radiol Clin North Am 2006; 44 (3) 391-406
- 24 Morrison WB, Sanders TG. Problem Solving in Musculoskeletal Imaging. Philadelphia, PA: Mosby Elsevier; 2008
- 25 Liu SH, Baker CL. Comparison of lateral ankle ligamentous reconstruction procedures. Am J Sports Med 1994; 22 (3) 313-317
- 26 St Pierre R, Allman Jr F, Bassett III FH, Goldner JL, Fleming LL. A review of lateral ankle ligamentous reconstructions. Foot Ankle 1982; 3 (2) 114-123
- 27 Woelffer KE, Figura MA, Sandberg NS, Snyder NS. Five-year follow-up results of instep plantar fasciotomy for chronic heel pain. J Foot Ankle Surg 2000; 39 (4) 218-223
- 28 Kim DH, Ryu S, Tiel RL, Kline DG. Surgical management and results of 135 tibial nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery 2003; 53 (5) 1114-1124 ; discussion 1124–1125
- 29 Gondring WH, Shields B, Wenger S. An outcomes analysis of surgical treatment of tarsal tunnel syndrome. Foot Ankle Int 2003; 24 (7) 545-550
- 30 Butterworth P, Gilheany MF, Tinley P. Postoperative infection rates in foot and ankle surgery: a clinical audit of Australian podiatric surgeons, January to December 2007. Aust Health Rev 2010; 34 (2) 180-185
- 31 Bauer TW, Schils J. The pathology of total joint arthroplasty.II. Mechanisms of implant failure. Skeletal Radiol 1999; 28 (9) 483-497
- 32 Resnick D, Kransdorf MJ. Bone and Joint Imaging. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2005
- 33 Beiner JM, Grauer J, Kwon BK, Vaccaro AR. Postoperative wound infections of the spine. Neurosurg Focus 2003; 15 (3) E14
- 34 Kaim AH, Gross T, von Schulthess GK. Imaging of chronic posttraumatic osteomyelitis. Eur Radiol 2002; 12 (5) 1193-1202
- 35 Dirschl DR, Almekinders LC. Osteomyelitis. Common causes and treatment recommendations. Drugs 1993; 45 (1) 29-43
- 36 Dick J, Boachie-Adjei O, Wilson M. One-stage versus two-stage anterior and posterior spinal reconstruction in adults. Comparison of outcomes including nutritional status, complications rates, hospital costs, and other factors. Spine 1992; 17 (8, Suppl) S310-S316
- 37 Thelander U, Larsson S. Quantitation of C-reactive protein levels and erythrocyte sedimentation rate after spinal surgery. Spine 1992; 17 (4) 400-404
- 38 Peterson JJ. Postoperative infection. Radiol Clin North Am 2006; 44 (3) 439-450
- 39 Della Valle CJ, Bogner E, Desai P , et al. Analysis of frozen sections of intraoperative specimens obtained at the time of reoperation after hip or knee resection arthroplasty for the treatment of infection. J Bone Joint Surg Am 1999; 81 (5) 684-689
- 40 Ehara S. Complications of skeletal trauma. Radiol Clin North Am 1997; 35 (3) 767-781
- 41 Weinstein MA, McCabe JP, Cammisa Jr FP. Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord 2000; 13 (5) 422-426
- 42 Teller RE, Christie MJ, Martin W, Nance EP, Haas DW. Sequential indium-labeled leukocyte and bone scans to diagnose prosthetic joint infection. Clin Orthop Relat Res 2000; 373 (373) 241-247
- 43 Tsukayama DT, Estrada R, Gustilo RB. Infection after total hip arthroplasty. A study of the treatment of one hundred and six infections. J Bone Joint Surg Am 1996; 78 (4) 512-523
- 44 Capitanio MA, Kirkpatrick JA. Early roentgen observations in acute osteomyelitis. Am J Roentgenol Radium Ther Nucl Med 1970; 108 (3) 488-496
- 45 Ebraheim NA, Coombs R, Rusin JJ, Jackson WT. Reduction of postoperative CT artifacts of pelvic fractures by use of titanium implants. Orthopedics 1990; 13 (12) 1357-1358
- 46 Haramati N, Staron RB, Mazel-Sperling K , et al. CT scans through metal scanning technique versus hardware composition. Comput Med Imaging Graph 1994; 18 (6) 429-434
- 47 Claus AM, Totterman SM, Sychterz CJ, Tamez-Peña JG, Looney RJ, Engh Sr CA. Computed tomography to assess pelvic lysis after total hip replacement. Clin Orthop Relat Res 2004; 422 (422) 167-174
- 48 Boas FE, Fleischmann D. Evaluation of two iterative techniques for reducing metal artifacts in computed tomography. Radiology 2011; 259 (3) 894-902
- 49 Robertson DD, Weiss PJ, Fishman EK, Magid D, Walker PS. Evaluation of CT techniques for reducing artifacts in the presence of metallic orthopedic implants. J Comput Assist Tomogr 1988; 12 (2) 236-241
- 50 White LM, Buckwalter KA. Technical considerations: CT and MR imaging in the postoperative orthopedic patient. Semin Musculoskelet Radiol 2002; 6 (1) 5-17
- 51 White LM, Kim JK, Mehta M , et al. Complications of total hip arthroplasty: MR imaging-initial experience. Radiology 2000; 215 (1) 254-262
- 52 Eustace S, Goldberg R, Williamson D , et al. MR imaging of soft tissues adjacent to orthopaedic hardware: techniques to minimize susceptibility artefact. Clin Radiol 1997; 52 (8) 589-594
- 53 Tartaglino LM, Flanders AE, Vinitski S, Friedman DP. Metallic artifacts on MR images of the postoperative spine: reduction with fast spin-echo techniques. Radiology 1994; 190 (2) 565-569
- 54 Sofka CM, Potter HG, Figgie M, Laskin R. Magnetic resonance imaging of total knee arthroplasty. Clin Orthop Relat Res 2003; 406 (406) 129-135
- 55 Sofka CM, Potter HG. MR imaging of joint arthroplasty. Semin Musculoskelet Radiol 2002; 6 (1) 79-85
- 56 Potter HG, Nestor BJ, Sofka CM, Ho ST, Peters LE, Salvati EA. Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue. J Bone Joint Surg Am 2004; 86-A (9) 1947-1954
- 57 Ledermann HP, Morrison WB, Schweitzer ME. MR image analysis of pedal osteomyelitis: distribution, patterns of spread, and frequency of associated ulceration and septic arthritis. Radiology 2002; 223 (3) 747-755
- 58 Olscamp AJ, Tao SS, Savolaine ER, Ebraheim NA. Postoperative magnetic resonance imaging evaluation of Pipkin fractures fixated with titanium implants: a report of two cases. Am J Orthop 1997; 26 (4) 294-297
- 59 Henk CB, Brodner W, Grampp S , et al. The postoperative spine. Top Magn Reson Imaging 1999; 10 (4) 247-264
- 60 Mueller PR, Stark DD, Simeone JF , et al. MR-guided aspiration biopsy: needle design and clinical trials. Radiology 1986; 161 (3) 605-609
- 61 Sofka CM. Optimizing techniques for musculoskeletal imaging of the postoperative patient. Radiol Clin North Am 2006; 44 (3) 323-329
- 62 van Trommel MF, Potter HG, Ernberg LA, Simonian PT, Wickiewicz TL. The use of noncontrast magnetic resonance imaging in evaluating meniscal repair: comparison with conventional arthrography. Arthroscopy 1998; 14 (1) 2-8
- 63 Potter HG, Rodeo SA, Wickiewicz TL, Warren RF. MR imaging of meniscal allografts: correlation with clinical and arthroscopic outcomes. Radiology 1996; 198 (2) 509-514
- 64 Hilfiker P, Zanetti M, Debatin JF, McKinnon G, Hodler J. Fast spin-echo inversion-recovery imaging versus fast T2-weighted spin-echo imaging in bone marrow abnormalities. Invest Radiol 1995; 30 (2) 110-114
- 65 Frazzini VI, Kagetsu NJ, Johnson CE, Destian S. Internally stabilized spine: optimal choice of frequency-encoding gradient direction during MR imaging minimizes susceptibility artifact from titanium vertebral body screws. Radiology 1997; 204 (1) 268-272
- 66 Love C, Tomas MB, Marwin SE, Pugliese PV, Palestro CJ. Role of nuclear medicine in diagnosis of the infected joint replacement. Radiographics 2001; 21 (5) 1229-1238
- 67 Zhuang H, Duarte PS, Pourdehand M, Shnier D, Alavi A. Exclusion of chronic osteomyelitis with F-18 fluorodeoxyglucose positron emission tomographic imaging. Clin Nucl Med 2000; 25 (4) 281-284
- 68 Zhuang H, Chacko TK, Hickeson M , et al. Persistent non-specific FDG uptake on PET imaging following hip arthroplasty. Eur J Nucl Med Mol Imaging 2002; 29 (10) 1328-1333
- 69 Chacko TK, Zhuang H, Stevenson K, Moussavian B, Alavi A. The importance of the location of fluorodeoxyglucose uptake in periprosthetic infection in painful hip prostheses. Nucl Med Commun 2002; 23 (9) 851-855
- 70 Palestro CJ, Torres MA. Radionuclide imaging in orthopedic infections. Semin Nucl Med 1997; 27 (4) 334-345
- 71 Spangehl MJ, Younger AS, Masri BA, Duncan CP. Diagnosis of infection following total hip arthroplasty. Instr Course Lect 1998; 47: 285-295
- 72 Palestro CJ. Musculoskeletal infection. In: Freeman LM, ed. Nuclear Medicine Annual. New York, NY: Raven Press; 1994: 91-119
- 73 Ashbrooke AB, Calvert PT. Bone scan appearances after uncemented hip replacement. J R Soc Med 1990; 83 (12) 768-769
- 74 Nadel HR, Stilwell ME. Nuclear medicine topics in pediatric musculoskeletal disease: techniques and applications. Radiol Clin North Am 2001; 39 (4) 619-651 , ix
- 75 Corstens FH, van der Meer JW. Nuclear medicine's role in infection and inflammation. Lancet 1999; 354 (9180) 765-770
- 76 Peters AM. The use of nuclear medicine in infections. Br J Radiol 1998; 71 (843) 252-261
- 77 Gratz S, Rennen HJ, Boerman OC , et al. 99mTc-HMPAO-labeled autologous versus heterologous leukocytes for imaging infection. J Nucl Med 2002; 43 (7) 918-924
- 78 Palestro CJ, Roumanas P, Swyer AJ, Kim CK, Goldsmith SJ. Diagnosis of musculoskeletal infection using combined In-111 labeled leukocyte and Tc-99m SC marrow imaging. Clin Nucl Med 1992; 17 (4) 269-273
- 79 Peters AM. The utility of [99mTc]HMPAO-leukocytes for imaging infection. Semin Nucl Med 1994; 24 (2) 110-127
- 80 Palestro CJ. Scintigraphic evaluation of infected hip and knee replacements. In: Thrall JH, ed. Current Practice of Radiology. St. Louis, MO: Mosby; 1993: 367-371
- 81 Palestro CJ, Kim CK, Swyer AJ, Capozzi JD, Solomon RW, Goldsmith SJ. Total-hip arthroplasty: periprosthetic indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur colloid imaging in suspected infection. J Nucl Med 1990; 31 (12) 1950-1955
- 82 Palestro CJ, Swyer AJ, Kim CK, Goldsmith SJ. Infected knee prosthesis: diagnosis with In-111 leukocyte, Tc-99m sulfur colloid, and Tc-99m MDP imaging. Radiology 1991; 179 (3) 645-648
- 83 Palestro CJ, Love C, Tronco GG, Tomas MB. Role of radionuclide imaging in the diagnosis of postoperative infection. Radiographics 2000; 20 (6) 1649-1660 ; discussion 1660–1663
- 84 De Winter F, Vogelaers D, Gemmel F, Dierckx RA. Promising role of 18-F-fluoro-D-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis 2002; 21 (4) 247-257
- 85 Van Acker F, Nuyts J, Maes A , et al. FDG-PET, 99mtc-HMPAO white blood cell SPET and bone scintigraphy in the evaluation of painful total knee arthroplasties. Eur J Nucl Med 2001; 28 (10) 1496-1504
- 86 Lyons CW, Berquist TH, Lyons JC, Rand JA, Brown ML. Evaluation of radiographic findings in painful hip arthroplasties. Clin Orthop Relat Res 1985; 195 (195) 239-251
- 87 Walker CW, FitzRandolph RL, Collins DN, Dalrymple GV. Arthrography of painful hips following arthroplasty: digital versus plain film subtraction. Skeletal Radiol 1991; 20 (6) 403-407
- 88 Ginai AZ, van Biezen FC, Kint PA, Oei HY, Hop WC. Digital subtraction arthrography in preoperative evaluation of painful total hip arthroplasty. Skeletal Radiol 1996; 25 (4) 357-363
- 89 Magnuson JE, Brown ML, Hauser MF, Berquist TH, Fitzgerald Jr RH, Klee GG. In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities. Radiology 1988; 168 (1) 235-239
- 90 Cuckler JM, Star AM, Alavi A, Noto RB. Diagnosis and management of the infected total joint arthroplasty. Orthop Clin North Am 1991; 22 (3) 523-530
- 91 Levitsky KA, Hozack WJ, Balderston RA , et al. Evaluation of the painful prosthetic joint. Relative value of bone scan, sedimentation rate, and joint aspiration. J Arthroplasty 1991; 6 (3) 237-244
- 92 Ali F, Wilkinson JM, Cooper JR , et al. Accuracy of joint aspiration for the preoperative diagnosis of infection in total hip arthroplasty. J Arthroplasty 2006; 21 (2) 221-226
- 93 Fehring TK, Cohen B. Aspiration as a guide to sepsis in revision total hip arthroplasty. J Arthroplasty 1996; 11 (5) 543-547
- 94 Tigges S, Stiles RG, Meli RJ, Roberson JR. Hip aspiration: a cost-effective and accurate method of evaluating the potentially infected hip prosthesis. Radiology 1993; 189 (2) 485-488
- 95 Perry CR, Pearson RL, Miller GA. Accuracy of cultures of material from swabbing of the superficial aspect of the wound and needle biopsy in the preoperative assessment of osteomyelitis. J Bone Joint Surg Am 1991; 73 (5) 745-749