Effect of Obesity on Total Ankle Arthroplasty Outcomes

Schipper, Oliver N.; Denduluri, Sahitya K.; Zhou, Ying; Haddad, Steven L.

doi:10.1177/1071100715604392

Cited by 58 publications

(45 citation statements)

References 30 publications

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“…15,23 A retrospective study found an increased long-term risk of implant failure in obese patients (BMI 30-45 kg/m 2 ), especially with the diagnosis of primary osteoarthritis. 31 While several studies have shown comparable success and complications between obese and nonobese patients, further studies are required to demonstrate outcomes specific to morbidly obese patients (BMI >40 kg/m 2 ). 1,2,6 Poorly controlled diabetes with neuropathy posed substantial challenge in wound healing, potential infection, postoperative weightbearing, and the development of Charcot's arthropathy.…”

Section: Discussionmentioning

confidence: 99%

Perspectives in Treatments of End-Stage Ankle Arthritis Among Orthopaedic Surgeons

Phisitkul

Glass

Ebeling

et al. 2018

Foot & Ankle Orthopaedics

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Background: This study aimed to assess the preferred operative treatment for patients over the age of 60 with end-stage ankle arthritis and perspectives on total ankle replacement (TAR) among American Orthopaedic Foot & Ankle Society (AOFAS) members. Associated factors were analyzed for potential contraindications among members with different levels of experience. Method: A questionnaire containing 6 questions was designed and sent to 2056 members of the AOFAS. Responses were received from 467 orthopaedic surgeons practicing in the United States (76%), Canada (5%), and 26 other countries (20%). Participants were grouped for response comparisons according to country as well as experience level. Differences in contraindications were compared using w 2 tests or exact tests. Results: Respondents practicing in the United States and surgeons who perform 11 or more TARs per year tended to recommend operative treatments favoring TAR and displayed recognition of its increasing role (P < .05). Overall, respondents felt that 41% of typical patients over 60 years old with end-stage arthritis would be best treated with TAR. Talus avascular necrosis, morbid obesity (body mass index >40 kg/m 2), and poorly controlled diabetes with neuropathy were most recognized as the absolute contraindications to TAR. Surgeon's experience affected the consideration of these clinical factors as contraindications. Conclusions: Total ankle replacement has a substantial and increasing role in the treatment of end-stage ankle arthritis in patients over the age of 60. Absolute and potential contraindications of the procedures were indicated from a crosssectional survey of AOFAS members. Surgeons more experienced with total ankle replacement felt more comfortable employing it in a wider range of clinical settings.

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Section: Discussionmentioning

confidence: 99%

Perspectives in Treatments of End-Stage Ankle Arthritis Among Orthopaedic Surgeons

Phisitkul

Glass

Ebeling

et al. 2018

Foot & Ankle Orthopaedics

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“…9 TAA in patients with a BMI > 30 have been recently shown to have a higher probability of implant failure at 5 years. 19 In addition, it has been demonstrated that BMI > 30 leads to a higher 90 day perioperative complication rate after TAA with 4.7% infection rate and 4.7% local complication rate. 23 Our infection rate in these patients was 7.1%.…”

Section: Discussionmentioning

confidence: 99%

“…This is less than the reported 20.6% rate found in the literature, however our study size was underpowered and we had a significantly shorter follow-up. 19 In addition to obesity, the patient who developed a wound infection had rheumatoid arthritis and was taking prednisone and Orencia (Abatacept). Complications after foot and ankle surgery in patients with rheumatoid arthritis is a well-known issue due to the nature of this systemic disease and the medications used to treat it.…”

Section: Discussionmentioning

confidence: 99%

A Review of Perioperative Complications of Outpatient Total Ankle Arthroplasty

Borenstein

Anand

et al. 2017

Foot Ankle Int.

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“…Although many investigations have evaluated the association of BMI and surgical complications in their secondary analyses (51,(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84), we identified 20 studies with hypotheses specifically addressing the effect of obesity on lower extremity surgery (85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104). These included studies on total ankle arthroplasty, pilon fracture ORIF, ankle fracture ORIF, calcaneal fracture ORIF, ankle arthrodesis, Achilles tendon repair, ankle arthroscopy, flatfoot reconstruction, and elective forefoot reconstruction.…”

Section: Preoperative Considerationsmentioning

confidence: 99%

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Meyr

Mirmiran

Naldo

et al. 2017

The Journal of Foot and Ankle Surgery

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A wide range of factors contribute to the complexity of the management plan for an individual patient, and it is the surgeon's responsibility to consider the clinical variables and to guide the patient through the perioperative period. In an effort to address a number of important variables, the American College of Foot and Ankle Surgeons convened a panel of experts to derive a clinical consensus statement to address selected issues associated with the perioperative management of foot and ankle surgical patients.

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Effect of Obesity on Total Ankle Arthroplasty Outcomes

Abstract: Level III, retrospective comparative series.

Cited by 58 publications

References 30 publications

Perspectives in Treatments of End-Stage Ankle Arthritis Among Orthopaedic Surgeons

Perspectives in Treatments of End-Stage Ankle Arthritis Among Orthopaedic Surgeons

A Review of Perioperative Complications of Outpatient Total Ankle Arthroplasty

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

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