TY - JOUR
T1 - Comparison of Short-Term Outcomes After Total Ankle Replacement and Ankle Arthrodesis
T2 - An ACS-NSQIP Database Study
AU - Anigian, Kendall
AU - Ahn, Juhno
AU - Wallace, S. Blake
AU - Manchanda, Kshitij
AU - Liu, George T.
AU - Raspovic, Katherine M.
AU - Van Pelt, Michael
AU - Wukich, Dane K.
AU - Lalli, Trapper A.J.
N1 - Publisher Copyright:
© 2021 The Author(s).
PY - 2023/6
Y1 - 2023/6
N2 - Over the past 2 decades, several studies comparing intermediate- and long-term outcomes after total ankle replacement (TAR) versus ankle arthrodesis (AA) have reported differing rates of complications and outcomes. Recently, there has been a dramatic increase in patients undergoing TARs without any epidemiologic studies examining the short-term and perioperative complications. The purpose of this prognostic study was to compare perioperative outcomes after TAR and AA using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database between 2012 and 2017. Patient data were collected from the NSQIP database for surgeries between January 2012 and December 2017 using Current Procedural Terminology codes 27700, 27702, 29899, and 27870. Patients were excluded if treated for fracture, infection, or revision procedures. The outcomes of interest were readmission and reoperation related to initial surgery, surgical site infections, and hospital length of stay. There were 1214 patients included—1027 (84.6%) TAR and 187 (15.4%) AA. The TAR patients were older, had a lower body mass index, and were less likely to have insulin-dependent diabetes. Readmission rate and length of stay was similar between groups. Multivariate regression revealed higher anesthesia severity scores (P =.0007), diabetes mellitus (P =.029), and AA (P =.049) had positive correlations with adverse outcomes. We report a lower complication rate with TAR than previously described. AA arthrodesis is associated with a higher risk of perioperative complications, including deep surgical site infections and reoperations. There were no differences between the 2 groups comparing superficial infection, wound dehiscence, or readmissions in the first 30 days. Levels of Evidence: Level V.
AB - Over the past 2 decades, several studies comparing intermediate- and long-term outcomes after total ankle replacement (TAR) versus ankle arthrodesis (AA) have reported differing rates of complications and outcomes. Recently, there has been a dramatic increase in patients undergoing TARs without any epidemiologic studies examining the short-term and perioperative complications. The purpose of this prognostic study was to compare perioperative outcomes after TAR and AA using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database between 2012 and 2017. Patient data were collected from the NSQIP database for surgeries between January 2012 and December 2017 using Current Procedural Terminology codes 27700, 27702, 29899, and 27870. Patients were excluded if treated for fracture, infection, or revision procedures. The outcomes of interest were readmission and reoperation related to initial surgery, surgical site infections, and hospital length of stay. There were 1214 patients included—1027 (84.6%) TAR and 187 (15.4%) AA. The TAR patients were older, had a lower body mass index, and were less likely to have insulin-dependent diabetes. Readmission rate and length of stay was similar between groups. Multivariate regression revealed higher anesthesia severity scores (P =.0007), diabetes mellitus (P =.029), and AA (P =.049) had positive correlations with adverse outcomes. We report a lower complication rate with TAR than previously described. AA arthrodesis is associated with a higher risk of perioperative complications, including deep surgical site infections and reoperations. There were no differences between the 2 groups comparing superficial infection, wound dehiscence, or readmissions in the first 30 days. Levels of Evidence: Level V.
KW - ankle
KW - arthroplasty
KW - fusion
KW - outcomes
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U2 - 10.1177/19386400211043363
DO - 10.1177/19386400211043363
M3 - Review article
C2 - 34713739
AN - SCOPUS:85118247720
SN - 1938-6400
VL - 16
SP - 300
EP - 306
JO - Foot and Ankle Specialist
JF - Foot and Ankle Specialist
IS - 3
ER -