Patient and Practice Trends in Total Ankle Replacement and Tibiotalar Arthrodesis in the United States from 2007 to 2013

Venus Vakhshori, Andrew F. Sabour, Ram K. Alluri, George F. Hatch, Eric W. Tan

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Introduction:Both total ankle replacement (TAR) and tibiotalar arthrodesis (TTA) are used in the surgical management of ankle arthritis. Over the past decade, TAR instrumentation, techniques, and implants have improved, making the procedure more reliable and reproducible, thus making TAR more common.Methods:The Nationwide Inpatient Sample database from 2007 to 2013 was used to obtain data on patients elder than 50 years who underwent either TAR or TTA. Differences in temporal, demographic, and diagnosis trends between TAR and TTA were analyzed.Results:Between 2007 and 2013, 15,060 patients underwent TAR and 35,096 underwent TTA. Patients undergoing TTA had significantly more comorbidities (2.17 versus 1.55; P < 0.001). The share of TAR performed increased significantly from 2007 (14%) to 2013 (45%) (P < 0.001). From 2007 to 2013, we found a 12-fold increase in the odds of having a TAR for patients with posttraumatic osteoarthritis (P < 0.001), a 4.9-fold increase for those with primary osteoarthritis, and a 3.1-fold increase for patients with rheumatoid arthritis (P < 0.001).Conclusions:Over the past decade, the frequency of TAR has increased, particularly in patients with posttraumatic arthritis and osteoarthritis. Surgeons still perform TAR in healthier patients compared with TTA; however, because surgeons become more experienced with the technique, patients are undergoing TAR at a markedly higher rate.Level of Evidence:Level III: retrospective comparative study.

Original languageEnglish (US)
Pages (from-to)E77-E84
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume27
Issue number2
DOIs
StatePublished - Jan 15 2019
Externally publishedYes

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Publisher Copyright:
© American Academy of Orthopaedic Surgeons.

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