Comparing 30-day all-cause readmission rates between tibiotalar fusion and total ankle replacement

Merrill, Robert; Ferrandino, Rocco; Hoffman, Ryan; Ndu, Anthony; Shaffer, Gene W.

doi:10.1016/j.fas.2017.12.011

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…In the present study, 67% of included patients with primary ankle OA received AA and 33% received TAR from 2010 through 2019. This proportion of TAR utilization is greater than the 13.10% 20 Rates of at least one major joint complication were higher at each postoperative follow-up for patients that underwent AA. However, with comparable rates of PJI and variable patient-specific factors that underlie preoperative planning, the ideal operative management of end-stage ankle OA remains unclear.…”

Section: Discussionmentioning

confidence: 77%

Complications Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Primary Ankle Osteoarthritis

Ross

Savage-Elliott

et al. 2021

Foot & Ankle Specialist

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Introduction There are minimal data comparing complications between ankle arthrodesis (AA) versus total ankle arthroplasty (TAR) for operative management of primary osteoarthritis (OA). This study aimed to compare outcomes following AA versus TAR for primary ankle OA using a large patient database. Methods Patients who received AA or TAR for primary ankle OA from 2010 to 2019 were queried from PearlDiver. Rates of common joint complications were compared at 90 days, 1 year, and 2 years postoperatively using multivariable logistic regression. Results A total of 1136 (67%) patients received AA and 584 (33%) patients underwent TAR. Patients that received AA exhibited significantly higher rates of at least one common joint complication at 90 days (19.3% vs 12.6%; odds ratio [OR] 1.69), 1 year (25.6% vs 15.0%; OR 2.00), and 2 years (26.9% vs 16.2%; OR 1.91) postoperatively. This included higher rates of adjacent fusion or osteotomy procedures, periprosthetic fractures, and hardware removal at each postoperative follow-up (all P < .05). Rates of prosthetic joint infection were comparable at 2 years postoperatively (4.3% vs 4.2%; OR 0.91). Conclusion The AA cohort exhibited higher rates of postoperative joint complications in the short and medium-term, namely, subsequent fusions or osteotomies, periprosthetic fractures, and hardware removal. Levels of Evidence Level III

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Section: Discussionmentioning

confidence: 77%

Complications Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Primary Ankle Osteoarthritis

Ross

Savage-Elliott

et al. 2021

Foot & Ankle Specialist

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“…Nonetheless, the perioperative major complications in ankle arthrodesis occurred 1.8 times more often but had a 29% lower risk of a minor complication after adjusting for patient and hospital factors, such as gender, age, and health-status [12]. These ndings are con rmed by the higher 30-day re-admission rate for ankle arthrodesis, which has an independent risk factor with an odds ratio of 2.51 [13].…”

Section: Introductionmentioning

confidence: 86%

Alignment of CCI total ankle replacements in relation to midterm functional outcome and complication incidence.

Hermus

Kuijk

Witlox

et al. 2022

Preprint

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Background: Total ankle arthroplasty is increasingly used as a treatment for endstage ankle arthropathy. The aim of our study was to report the mid-term clinical function and survival results of Ceramic Coated Implant (CCI) ankle replacements and assess the association between the alignment of the CCI total ankle replacements and early functional outcome and complication incidence.Methods: Data of 61 patients, who received 65 CCI implants between 2010 and 2016, were obtained from a prospectively documented database. Mean follow-up time was 85.2 months (range 27-99 months). Clinical function was assessed with AOFAS questionnaire and passive range of motion (ROM). Survival analysis and elaborate radiographic analysis was performed. Furthermore, complications and re-operations were recorded for all patients Results: Progression in ROM was most seen in the first 10 months from 21.8 degrees of passive range of motion preoperative to 27.6 degrees postoperative (p< 0.001), while the AOFAS gradually increased till 16 months postoperative from a mean of 40.9 points preoperative to an average of 82.5 over the whole follow up period of 7.1 years (p < 0.001). During follow-up we recorded 8 failures (12.3%) resulting in a Kaplan-Meier survival analysis of 87.7% with a median follow-up of 85.2 months. Conclusion: We observed excellent clinical results and survival after TAA with the CCI implant with only a low mid-term complication rateLevel of Evidence: Level III, prospective cohort study

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“…3 Independent risk factors related to readmission were related to deficiency anemia, coagulopathy, renal failure, other insurance relative to private, and tibiotalar fusion. 4 However, the revision rate of ankle arthroplasty is much higher than that of ankle fusion. 5 It has also been reported that the failure rate of ankle joint replacement is relatively high, which is related to 45% of poor alignment after operation.…”

Section: Introductionmentioning

confidence: 99%

“…A systematic meta‐analysis of gait biomechanics after TAR showed that patio‐temporal, kinematic and kinetic gait patterns were improved when compared to pre‐operation, yet gait biomechanics after ankle arthrodesis were not improved due to walking speed and ankle movement 3 . Independent risk factors related to readmission were related to deficiency anemia, coagulopathy, renal failure, other insurance relative to private, and tibiotalar fusion 4 …”

Section: Introductionmentioning

confidence: 99%

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A Novel Method for Preoperative Positioning of Total Ankle Replacement Using 3D Digital Model

Liu

Ling

et al. 2022

Orthopaedic Surgery

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Objective: To establish a digital model of the ankle joint through 3D imaging technology and explore the preoperative placement of ankle replacement prostheses.Methods: Computed tomography images of intact ankle joints from 54 cases in the outpatient and inpatient departments of our hospital were collected; according to the INBONE ® total ankle system surgery process, the surgery model and surgical osteotomy were finished using MIMICS based on computer simulation method. The shortest distance was measured between the center point and the anterior, posterior, medial, and lateral, respectively, to ensure the precise position of the ankle replacement prosthesis by digital simulation surgery. The relationship between the two variables was analyzed by bivariate correlation analysis. Results:The dataset of this study included 48 cases of the sub-data set (26 males and 22 females) and included 27 cases of left ankle and 21 cases of right ankle. The average medial malleolar angle was 18.67 AE 2.87 , the average amount of bone resection was 12.13 AE 1.86 cm 3 , the mid-anterior distance was 1.72 AE 0.19 cm, the midposterior distance was 2.00 AE 0.19 cm, the ratio of mid-anterior to mid-posterior was 0.87, the mid-medial distance was 1.26 AE 0.17 cm, the mid-lateral distance was 1.19 AE 0.16 cm, and the ratio of mid-medial to mid-lateral was 1.06. After osteotomy, the anteroposterior diameter was 3.73 AE 0.32 cm, the transverse diameter was 2.46 AE 0.27 cm, and the ratio of anteroposterior diameter to transverse diameter was 1.53. In the bottom view, the shape after osteotomy is rectangular. The mid-anterior distance was strongly negatively correlated with age, the midanterior distance and the amount of bone resection, the mid-medial distance and the amount of bone resection, the mid-lateral distance and the amount of bone resection, the mid-lateral distance and the anteroposterior diameter, the anteroposterior diameter and the transverse diameter were all strongly positively correlated. Conclusion:The projection point of the lower tibia centerline on the tibial horizontal osteotomy surface is located at a position slightly anterior to the midpoint of the transverse diameter after ankle arthroplasty. The rational positioning of the total ankle replacement is located at both a position slightly anterior to the midpoint of the transverse diameter and midpoint of the anteroposterior diameter, which can be used as a reference method before total ankle arthroplasty surgery.

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Comparing 30-day all-cause readmission rates between tibiotalar fusion and total ankle replacement

Cited by 12 publications

References 26 publications

Complications Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Primary Ankle Osteoarthritis

Complications Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Primary Ankle Osteoarthritis

Alignment of CCI total ankle replacements in relation to midterm functional outcome and complication incidence.

A Novel Method for Preoperative Positioning of Total Ankle Replacement Using 3D Digital Model

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