Racial Disparities in Total Ankle Arthroplasty Utilization: A National Database Analysis

Background: Total ankle arthroplasty (TAA) is successful at reducing pain and improving patient satisfaction. A paucity of literature exists regarding racial disparities in TAA. The aim of this study was to update the literature, analyze utilization rates, and detect differences in postoperative outcomes between the racial/ethnic groups. Methods: A retrospective study was performed utilizing the National Surgical Quality Improvement Program (NSQIP) database between the years 2012 and 2018. The postoperative complications were identified as outcomes. Patients were categorized based on race/ethnicity for comparison. A p-value less than 0.05 was considered significant. Results: 1164 patients met criteria, 1051 (90.3%) were White, 113 (9.7%) were Non-White, a nearly 10-fold difference in utilization rate. The mean age of White patients undergoing TAA was older than Non-White patients, 63.7 and 55.3 years respectively (p-value < 0.01). Incidence of postoperative complications showed no significant differences based on racial group. Conclusions: Our results found a nearly 10-fold difference in White patients undergoing TAA compared to other racial/ethnic groups. This highlights the continued racial disparities present in TAA. Further efforts are needed to improve the proportion of minority populations who undergo TAA to bridge the current racial disparities present in the field of TAA.