Industry Payments to Foot and Ankle Surgeons and Their Effect on Total Ankle Arthroplasty Outcomes

Abstract

Background: The Centers for Medicare & Medicaid Services (CMS) Open Payments public database provides a means for increased transparency of physicians’ financial relationships with industry. Total ankle arthroplasty is a procedure with long-term clinical implications and variable outcomes. We compared physician-reported conflict-of-interest (COI) disclosures in the journal Foot & Ankle International ( FAI) to CMS database information to evaluate for discrepancies. Methods: Articles published in FAI reporting clinical outcomes of total ankle arthroplasty from 2015 and 2019 were reviewed. Payment information in the CMS database was cross-referenced with disclosure statements and International Committee of Medical Journal Editors (ICMJE) forms associated with the manuscript. Statistical analysis was performed to determine if industry payments were appropriately disclosed or influenced outcomes. Results: We reviewed 173 articles pertaining to ankle arthroplasty, with 27 meeting inclusion criteria. Of 120 total authors with 98 unique authors, 114 (95%) disclosed appropriately in disclosure statements. Twenty-two studies (82%) had appropriate declarations for the entire manuscript. For the 27 senior authors, only 2 discrepancies between manuscript disclosure and the Open Payments public database were noted, showing 13 total disclosures in the Open Payments public database vs 11 disclosed in the manuscript. There was no relationship between industry payments and the outcome of the manuscript ( P = .725). Conclusion: The majority of author disclosure statements accurately reflected the Open Payments public data. Additionally, payments were not significantly associated with positive outcomes reported for the specific implant. Overall, authors publishing on ankle arthroplasty in FAI are disclosing appropriately. Level of Evidence: Level IV, systematic review; survey study; literature review.

Funding has no effect on clinical outcomes of total joint arthroplasty emerging technologies: a systematic review of bibliometrics and conflicts of interest

“…Interestingly, the authors found that the apparent association between funding and outcome was stronger in The Journal of Arthroplasty than in either of the other journals reviewed, which they noted may be a function of a substantial industry presence in the subspecialty of joint replacement. More recent investigations of the influence of COIs on study conclusions in various other orthopedic subspecialty fields have produced conflicting results [28,[34][35][36]. In the current investigation, studies of emerging TJA technologies in which any author reported a COI were not more likely to report favorable results than those without any author COIs.…”

Costs and Outcomes of Total Joint Arthroplasty in Medicare Beneficiaries Are Not Meaningfully Associated with Industry Payments

“…A recent study demonstrated that industry payments were not associated with total costs or operating room costs of anterior cervical discectomy and fusion 15 . Other studies found that industry payments were not associated with the outcomes of ankle arthroplasty, as reported in Foot & Ankle Orthopaedics 25 , or shoulder arthroplasty, as reported in the Journal of Shoulder and Elbow Surgery 26 . In contrast to previously reported significant associations between industry payments and physician prescribing patterns 11,27,28 , our findings suggest that overall TJA surgical costs and outcomes are not substantially impacted by industry payments.…”