Abstract
Although total ankle arthroplasty (TAA) is becoming a progressively common procedure
with a reported 10-fold increase in its prevalence over the past 2 decades; there
is still limited large-scale data regarding its overall outcome. Using the National
Inpatient Sample (NIS) database, patients who underwent TAA between 2016 and 2019
were identified (ICD-10 CMP code). Data regarding demographic details, co-morbidities,
geographic locations of procedure, hospital stay, expenditure incurred, and complications
encountered were analyzed. Additionally, a comprehensive subgroup analysis was performed
to evaluate the impact of multiple preoperative variables (including gender, diabetes,
obesity, CKD and tobacco abuse) on the patient outcome. Overall, 5087 patients (mean
age: 65.1 years, 54% males, 85% Caucasians, 75% from large metropolitan regions) underwent
TAA. Eighty eight percent of patients were discharged to home; and the mean length
of hospital stay and hospital-related expenditure were 1.7 ± 1.41 days and $92,304.5
± 50,794.1, respectively. The overall complication rate was 8.39% {commonest medical
complications: anemia [131 (2.6%) patients) and acute renal failure [37 (0.7%) patients];
commonest local complication: periprosthetic mechanical adversities [90 (1.7%) patients]}.
Female and CKD patients demonstrated significantly higher risks of medical (female:
p = .003; CKD: p < .001) and surgical (female: p = .005; CKD: p < .019) complications; while obesity substantially enhanced the risk of medical adversities
(p < .001). Based on our study, we could conclude that the rates of TAA in the United
States are on the rise, especially in regions with population greater than 250,000.
TAA is a safe procedure with relatively low complication rates. The complications
and hospital-associated expenditure seem to vary between different patient subgroups.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: August 19, 2022
Footnotes
Financial Disclosure: None.
Conflicts of Interest: None.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.
