scholarly journals Perioperative Complications of Outpatient Total Ankle Arthroplasty

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Todd Borenstein ◽  
David B. Thordarson ◽  
Timothy P. Charlton ◽  
Stephanie Chen
Keyword(s):  
Revision Surgery ◽  
Outpatient Surgery ◽  
Perioperative Complications ◽  
Arterial Occlusion ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Outpatient Management ◽  
Ankle Arthroplasty ◽  
Wound Breakdown

Category: Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. As the number of TAA increases, so too will the associated economic burden. In the current healthcare environment, savings are in the national spotlight. Studies of total joint arthroplasty (THA and TKA) have demonstrated that outpatient surgery decreases surgical costs.1,2 Additionally, outpatient THA and TKA have not been associated with increased complication or readmission rates.3–6 Outpatient TAA are becoming more common which may lead to decreased costs of care. Despite the potential savings, TAA remains an “inpatient-only procedure” for Medicare patients. Currently, there are no clinical studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive outpatient TAA to identify complication rates and patient risk factors. Methods: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum of 6-month follow-up were reviewed. All patients received popliteal and saphenous blocks with bupivacaine and epinephrine prior to surgery and were managed with oral NSAID and narcotic pain medication post-operatively. All patients received a STAR total ankle prosthesis. Demographics, comorbidities, ASA and perioperative complications including wound breakdown, infection, revision and non-revision surgeries were compared to historic controls. Mean follow up was 16.6 +/- 9.1 months (range, 6-42 months). Results: The overall complication rate in this series was 21.8%. One ankle (1.5%) had a wound breakdown requiring debridement and flap coverage. This patient had a history of Polycythemia Vera with re-thrombosis of their popliteal artery one month after TAA surgery. Two ankles (3%) had deep infections. Nine ankles (13.8%) required non-revision surgery. Three ankles (4.6%) required posterior capsular release, one ankle (1.5%) required medial malleolar screws for symptomatic stress reaction, and three ankles (4.6%) required arthroscopic or open gutter release. Two ankles (3%) required revision surgery. One for talar component subsidence in a patient with Charcot-Marie-Tooth managed with an arthrodesis at eleven months. The other revision was performed for aseptic tibial component loosening and managed with conversion to an INBONE prosthesis at seven months. Conclusion: This study demonstrates the safety of outpatient TAA. The combination of regional anesthesia and oral narcotics provided a satisfactory outpatient experience and zero patients required readmission for pain control. The one wound complication (1.5%) was attributed to arterial occlusion and not outpatient management. This compares to the 6.6-28% wound breakdown rate found in the literature.7–10 Our revision surgery rate (3%) was comparable to the 3.1-16.5% rate found in the literature, and was also not attributed to outpatient management.7–10 We feel this demonstrates that outpatient TAA can be performed safely.

A Review of Perioperative Complications of Outpatient Total Ankle Arthroplasty

2017 ◽  
Vol 39 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Todd R. Borenstein ◽  
Kapil Anand ◽  
Quanlin Li ◽  
Timothy P. Charlton ◽  
David B. Thordarson
Keyword(s):  
Wound Infection ◽  
Pain Control ◽  
Perioperative Complications ◽  
Case Series ◽  
Arterial Occlusion ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Ankle Arthroplasty ◽  
Wound Breakdown

Background: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. Methods: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed. All patients received popliteal and saphenous blocks prior to surgery and were managed with oral pain medication postoperatively. All received a STAR total ankle. Demographics, comorbidities, American Society of Anesthesiologists (ASA) class, and perioperative complications including wound breakdown, infection, revision, and nonrevision surgeries were observed. Mean follow-up was 16.6 ± 9.1 months (range, 6-42 months). Results: There were no readmissions for pain control and 1 patient had a wound infection. The overall complication rate was 15.4%. One ankle (1.5%) had a wound breakdown requiring debridement and flap coverage. This patient thrombosed a popliteal artery stent 1 month postop. The 1 ankle (1.5%) with a wound infection occurred in a patient with diabetes, obesity, hypertension, and rheumatoid arthritis. Conclusion: This study demonstrates the safety of outpatient TAA. The combination of regional anesthesia and oral narcotics provided a satisfactory experience with no readmissions for pain control and 1 wound infection. The 1 wound breakdown complication (1.5%) was attributed to arterial occlusion and not outpatient management. Level of Evidence: Level IV, retrospective case series.

scholarly journals Effect of Travel Time and Distance on Outcomes in Total Ankle Arthroplasty

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0015
Author(s):  
Kristin C. Caolo ◽  
Scott J. Ellis ◽  
Jonathan T. Deland ◽  
Constantine A. Demetracopoulos
Keyword(s):  
Travel Time ◽  
Complication Rate ◽  
High Volume ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Linear Regression Models ◽  
Ankle Arthroplasty ◽  
Significant Difference ◽  
Drive Time

Category: Ankle; Ankle Arthritis Introduction/Purpose: Surgeons who perform a higher volume of total ankle arthroplasty (TAA) are known to have decreased complication rates; evidence shows that low volume centers performing TAA have decreased survivorship when compared with high volume centers. Understanding differences in outcomes for patients traveling different distances for their TAA is important for future patients deciding where to travel for their surgery. No study has previously examined differences in outcomes of patients traveling different distances to a high volume center for their TAA. This study compares preoperative and postoperative PROMIS scores for patients undergoing total ankle arthroplasty who traveled less than and more than 50 miles for their TAA. We hypothesized that there would be no difference in outcome scores based on distance traveled or estimated drive time. Methods: This study is a single center retrospective review of 162 patients undergoing primary total ankle arthroplasty between January 2016 and December 2018. We collected the primary address as listed in the patient’s medical record and used the directions feature on Google Maps to estimate driving mileage and estimated driving time from the patient’s address to the hospital. To analyze the distance patients traveled, patients were divided into two groups: <50 miles traveled (n=91) and >50 miles traveled (n=71). To analyze the estimated drive time, patients were divided into two groups: <90 minutes (n=77), >90 minutes (n=85). We collected preoperative and most recent postoperative PROMIS scores for all patients. Differences in most recent post-operative PROMIS scores between distance groups and travel time groups were assessed using multivariable linear regression models, adjusting for the pre-operative score and follow-up time. Results: We found no significant difference in post-operative PROMIS scores between the two groups when analyzed for distance traveled or for estimated travel time after adjustment for pre-operative PROMIS score and follow-up time (Table 1). The average follow-up for all 162 patients was 1.49 years. Power analysis showed that with a sample size of 110 (55 in each group), we had 81% power to detect an effect size of 4. Patients saw an increase in their Physical Function scores and a decrease in their Pain Interference and Pain Intensity scores with postoperative scores better than population means (Table 1). Overall complication rate for the <50 miles group was 17.6%, 7.7% required surgery. The >50 miles group had an overall complication rate of 24.0%, 9.9% required surgery. Conclusion: Patients traveling further distances to a high volume orthopedic specialty hospital for their total ankle arthroplasty do not have different clinical outcomes than patients traveling shorter distances. This is particularly important for patients deciding where to have their total ankle arthroplasty surgery. Patients who travel further have the opportunity to be treated at a local academic center; however our results show that outcomes do not change when traveling further for total ankle arthroplasty. [Table: see text]

Economic Analysis and Patient Satisfaction Associated With Outpatient Total Ankle Arthroplasty

2017 ◽  
Vol 38 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Tyler Gonzalez ◽  
Erica Fisk ◽  
Christopher Chiodo ◽  
Jeremy Smith ◽  
Eric M. Bluman
Keyword(s):  
Patient Satisfaction ◽  
Outpatient Surgery ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Ankle Arthroplasty ◽  
Proper Patient Selection ◽  
Estimated Blood Loss ◽  
Outpatient Group ◽  
Inpatient Group ◽  
Ed Visits

Background: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis. Methods: From July 2010 to September 2015, a total of 36 patients underwent TAA. Patients with prior ankle replacement, prior ankle infections, neuroarthropathy, or osteonecrosis of the talus were excluded from the study. All patient demographics, tourniquet times, estimated blood loss, comorbidities, concomitant procedures, complications, return ED visits, and readmissions were recorded. Patient satisfaction questionnaires were collected. Twenty-one patients had outpatient surgery and 15 had inpatient surgery. The cohorts were matched demographically. Results: The average length of stay for the inpatient group was 2.5 days. The overall cost differential between the groups was 13.4%, with the outpatient group being less costly. This correlates to a cost savings of nearly $2500 per case. One patient in the outpatient group had a return ED visit on postoperative day 1 for urinary retention. There were no 30-day readmissions in either group. Seventy-one percent of the outpatient group and 93% of the inpatient group would not change to a different postoperative admission status if they were to have the procedure again. Conclusion: Our results show that OTAA was a cost-effective and safe alternative with low complication rates and high patient satisfaction. With proper patient selection, OTAA was beneficial to both the patient and the health care system by driving down total cost. It has the capacity to generate substantial savings while providing equal or better value to the patient. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

2020 ◽  
Author(s):  
Gun-Woo Lee ◽  
Keun-Bae Lee
Keyword(s):  
Mobile Bearing ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Gender Influence ◽  
Implant Survivorship ◽  
The Difference ◽  
American Orthopaedic

Abstract Background: Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods: This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results: Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and the difference was not statistically significant between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions: Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.

Effect of age on outcome and revision in total ankle arthroplasty

2020 ◽  
Vol 102-B (7) ◽  
pp. 925-932 ◽  
Author(s):  
Mario Gaugler ◽  
Nicola Krähenbühl ◽  
Alexej Barg ◽  
Roxa Ruiz ◽  
Tamara Horn-Lang ◽  
...  
Keyword(s):  
Pain Relief ◽  
Clinical Outcome ◽  
Revision Surgery ◽  
Preoperative Assessment ◽  
Total Ankle Arthroplasty ◽  
Consecutive Series ◽  
Ankle Arthroplasty ◽  
Major Revision ◽  
Effect Of Age

Aims To assess the effect of age on clinical outcome and revision rates in patients who underwent total ankle arthroplasty (TAA) for end-stage ankle osteoarthritis (OA). Methods A consecutive series of 811 ankles (789 patients) that underwent TAA between May 2003 and December 2013 were enrolled. The influence of age on clinical outcome, including the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and pain according to the visual analogue scale (VAS) was assessed. In addition, the risk for revision surgery that includes soft tissue procedures, periarticular arthrodeses/osteotomies, ankle joint debridement, and/or inlay exchange (defined as minor revision), as well as the risk for revision surgery necessitating the exchange of any of the metallic components or removal of implant followed by ankle/hindfoot fusion (defined as major revision) was calculated. Results A significant improvement in the AOFAS hindfoot score and pain relief between the preoperative assessment and the last follow-up was evident. Age had a positive effect on pain relief. The risk for a minor or major revision was 28.7 % at the mean follow-up of 5.4 years and 11.0 % at a mean follow-up of 6.9 years respectively. The hazard of revision was not affected by age. Conclusion The clinical outcome, as well as the probability for revision surgery following TAA, is comparable between younger and older patients. The overall revision rate of the Hintegra total ankle is comparable with other three component designs. TAA should no longer be reserved for low demand elderly patients, but should also be recognized as a viable option for active patients of younger age. Cite this article: Bone Joint J 2020;102-B(7):925–932.

scholarly journals Revision Surgery for Metal Component Failure in Total Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0007
Author(s):  
James Lachman ◽  
Jania A. Ramos ◽  
Samuel Adams ◽  
Mark Easley ◽  
James DeOrio
Keyword(s):  
Revision Surgery ◽  
Short Form ◽  
Total Ankle Arthroplasty ◽  
Study Patient ◽  
Foot And Ankle ◽  
Metal Component ◽  
Component Failure ◽  
Ankle Arthroplasty ◽  
Patient Reported

Category: Ankle Arthritis Introduction/Purpose: Metal component failure in total ankle arthroplasty(TAA) is difficult to treat. Traditionally, to an arthrodesis has been advocated. Revision TAA surgery has become more and more common with availability of revision implants and refinement of bone conserving primary implants. It this study, patient reported results and clinical outcomes are analyzed for patients undergoing revision total ankle arthroplasty. Methods: We retrospectively reviewed prospectively collected data on 45 patients (cases) with a mean age of 63.7 +/-10.2 years who developed loosening or collapse of either major metal component in the primary total ankle arthroplasty. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. Prospectively collected patient reported outcomes measures including the American Orthopaedic Foot and Ankle Society(AOFAS) hindfoot score, Visual Analog Scale (VAS), Short Form 36 (SF-36), Short Musculoskeletal Function Assessment (SMFA), and the Foot and Ankle Outcomes Score (FAOS) questionnaires were collected. Clinical data was collected through thorough review of the electronic medical record to identify clinical failure defined as explant and second revision or conversion to arthrodesis or amputation. Results: The causes of failure of primary TAA in this study were aseptic loosening of both components (40%), talar component subsidence/loosening (37.7%), tibial loosening (8.8%), coronal talar subluxation (8.8%) and talar malrotation (2.2%). Twenty-four patients (53.3%) underwent revision of all components, nineteen (42.2%) just the talar and polyethylene components, and two (4.4%) the tibial and polyethylene components. The average time to revision was 5.56 years +/- 5.71 with a follow-up of 3.02 years +/- 1.25 after revision. Ten (22.2%) revision arthroplasties required further surgery; five required conversion to arthrodesis and five required second revision TAA. VAS scores, SF36 scores, SMFA scores, AOFAS Hindfoot scores, and FAOS all improved after revision surgery but took 2 years to reach scores comparable to 1 year after primary TAA. Conclusion: Clinical and patient reported results of revision ankle arthroplasty after metal component failure were comparable to those after primary ankle arthroplasty. In our series, 22.2% of revision TAAs required a second revision TAA or arthrodesis surgery. Various prosthesis performed similarly when used in revision scenarios. Patients recovered faster from primary ankle arthroplasty when compared to revision ankle arthroplasty but all scores were comparable by the two-year follow-up visit after revision arthroplasty surgery.

scholarly journals Early Outcomes and Complications Following Initiation of a Total Ankle Arthroplasty Program

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142098578
Author(s):  
Gregory Lundeen ◽  
Kaitlin C. Neary ◽  
Cody Kaiser ◽  
Lyle Jackson
Keyword(s):  
Intraoperative Complications ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Radiographic Evaluation ◽  
Wound Complications ◽  
Consecutive Series ◽  
Complication Rates ◽  
Ankle Arthroplasty ◽  
Intermediate Outcomes

Background: Surgeons who lack experience with total ankle arthroplasty (TAA) may remain hesitant to introduce this procedure owing to previously published results of high complication rates during initial cases. The purpose of the present study was to report the development of a TAA program through intermediate outcomes and complications for an initial consecutive series of TAA patients of a single community-based foot and ankle fellowship–trained orthopedic surgeon with little TAA experience using a co-surgeon with similar training and TAA exposure. Methods: The initial 20 patients following third-generation TAA with a single surgeon were reviewed. Clinical outcomes were measured and radiographs were evaluated to determine postoperative implant and ankle position. Complications were also measured including intraoperative, early (<3 months), and intermediate postoperative complications. Results: With a minimum follow-up of 2 years and average follow-up of 51 months (range 24-70 months), the mean American Orthopaedic Ankle & Foot Society Ankle-Hindfoot score was 87.7 (59-100) and VAS was 1.0 (0-5.5). All patients were improved following TAA. Radiographic evaluation demonstrated no evidence of component malalignment or ankle joint incongruity. There were no intraoperative complications nor any wound complications. Three patients returned to the operating room for placement of medial malleolar screw placement, and 1 had asymptomatic tibial component subsidence. Conclusions: Orthopedic surgeons with a proper background and updated training may be able to perform TAA with good outcomes. A TAA program was developed to define minimum training criteria to perform this procedure in our community. Our complication rate is consistent with those reported in the literature for experienced TAA centers, which contrasts previous literature suggesting increased complication rates and worse outcomes when surgeons perform initial TAAs. Utilization of an orthopedic co-surgeon was felt to be instrumental in the success of the program. Level of Evidence: Level IV, retrospective case series.

scholarly journals Total Ankle Arthoplasty as a Day Case Surgery: How Safe and Effective it is?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0027
Author(s):  
Shahin Kayum ◽  
Timothy R. Daniels ◽  
Ryan M. Khan
Keyword(s):  
Pain Control ◽  
Surgical Procedure ◽  
Perioperative Complications ◽  
Cost Effective ◽  
Total Ankle Arthroplasty ◽  
Average Score ◽  
Ankle Arthroplasty ◽  
Post Surgery ◽  
Wound Breakdown ◽  
Oral Pain

Category: Ankle Arthritis Introduction/Purpose: Outpatient total joint arthroplasty (OTJA) allows for a safe, cost effective pathway for appropriately selected patients. Total ankle arthroplasty (TAA) is a surgical procedure commonly used for patients with painful arthritis. As the number of TAA procedures increase, so does the associated economic burden. The purpose of this study was to evaluate patients undergoing total ankle arthroplasty, who were discharged on the same day as undergoing surgery. These patients have stayed in the hospital for <12 hours, and are referred to as ‘‘outpatients.’’ Outpatients were evaluated with regard to the following outcomes: (1) postoperative pain; (2) perioperative complications and healthcare provider visits (readmission). We also assessed patients’ satisfaction regarding discharge on the same day as surgery. Methods: The medical records of 46 consecutive TAA outpatients from July 2018 to June 2019 with a minimum 1 month post- operative follow-up, were reviewed. All patients received an Integra Cadence TAA. Prior to surgery, all patients received popliteal blocks. Patients were discharged home with a popliteal catheter, which they were to remove themselves after 48 hours. After removal of the catheter, patients were prescribed oral pain medication to help with any pain or discomfort. The following data was collected: demographics, comorbidities, (ASA) class, and perioperative complications, including wound breakdown, infection, revision and non-revision surgeries. At their 1-month post-operative visit, patients completed a questionnaire regarding their satisfaction post-surgery, which consisted of six questions. Results: There were no readmissions for pain control, no signs of wound infection among the 46 outpatients. All patients were ‘very satisfied’ with the surgical procedure and with recommend methods of pain control. The majority of patients were also very satisfied with discharge on the same day as surgery with the exception of patients who would have liked to stay overnight. When asked if they would recommend the care they experienced to a friend with the same condition, 46 patients said that they would definitely recommend this process to a friend. In terms of rating their pain on a scale of 0-10 (0 being no pain, 10 being worst pain imaginable), the average score for the 46 patients was 2.03. Conclusion: Our study demonstrates the safety of outpatient TAA. The combination of regional anesthesia and oral narcotics provided a satisfactory outpatient experience and no readmissions for pain control.

scholarly journals Outcomes of Revision Ankle Arthroplasty using a Fixed-bearing, Stemmed Intramedullary Prosthesis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003 ◽  
Author(s):  
Oliver Schipper ◽  
Steven Haddad ◽  
Alexander Van den Avont
Keyword(s):  
Revision Surgery ◽  
Plantar Flexion ◽  
Treatment Options ◽  
Total Ankle Arthroplasty ◽  
Medial Malleolus ◽  
Fixed Bearing ◽  
Ankle Arthroplasty ◽  
Additional Surgery ◽  
The Mean

Category: Ankle, Ankle Arthritis Introduction/Purpose: As in all total joint arthroplasty, longevity is finite, and the need for predictable revision surgery is mandatory. Literature is sparse describing revision total ankle arthroplasty (TAA) feasibility and outcomes. Revision total ankle arthroplasty involving implant exchange remains in its infancy, making critical assessment of outcomes necessary to guide future treatment options. The purpose of this study was to analyze the clinical outcomes of revision TAA using a minimum 2-year follow-up to evaluate for early failure and outcomes. Methods: Retrospective chart review identified 18 patients that underwent revision of their TAA to a third generation FDA approved fixed-bearing, intramedullary stemmed implant with a minimum 2 year follow up. Once identified, all patients were contacted for an in-office outcomes questionnaire, examination, and radiographic follow up. Outcomes included the Foot & Ankle Disability Index (FADI) Score, Foot Function Index (FFI), Visual Analog Scale (VAS) used for pain, and ankle range of motion. Results: The mean age of patients at the time of revision was 59.6±9.7years and the mean follow up was 4.2±2.1 years. The mean FADI score was 69.9±17.9, the mean FFI was 49.1±15.2, and the mean VAS score was 33.3±25.8. Mean ankle dorsiflexion was 19.6±7.8 degrees and mean ankle plantar flexion was 18.6±7.5degrees. Postoperative complications included one infection requiring irrigation and debridement with hardware removal for a medial ankle soft tissue abscess, and one medial malleolus fracture that underwent open reduction and internal fixation. Three revision prostheses failed during the follow-up period, requiring additional surgery. Reasons for failure included talar subsidence in 2 patients secondary to osteolysis and/or avascular changes to the talus, and medial/lateral gutter impingement due to an oversized talar component in 1 patient. Conclusion: Revision of ankle arthroplasty requires significant planning in extraction of the failed prosthesis, implantation of the revision prosthesis, and alignment of the foot. Major complications are potentially avoidable through careful bone assessment prior to revision surgery, and results are acceptable in this early follow-up study using a fixed-bearing intramedullary stemmed implant system.

scholarly journals Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

2020 ◽  
Author(s):  
Gun-Woo Lee ◽  
Keun-Bae Lee
Keyword(s):  
Mobile Bearing ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Foot And Ankle ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Gender Influence ◽  
Implant Survivorship ◽  
American Orthopaedic

Abstract Background Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and were not significantly different between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.

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