Short Term Adverse Events Following Ankle Arthroplasty and Ankle Arthrodesis: A Matched Analysis of Recent Nationally-Representative Data

Category: Ankle Arthritis; Ankle Introduction/Purpose: Surgical management of ankle osteoarthritis (AOA) includes Ankle Arthrodesis (AA) or Total Ankle Arthroplasty (TAA). Existing literature has been inconclusive regarding a clear standard of treatment for AOA. The purpose of this study was to analyze data from the National Surgical Quality Improvement Project (NSQIP) to elucidate differences in outcomes between TAA and AA. Methods: Patients who underwent TAA or AA from January 2010 to December 2020 in the NSQIP database were included in this analysis. All patients were followed for at least 30 days following surgery. The independent variable was procedure type: AA or TAA. The dependent variables were complications. Independent sample t-tests and chi square tests were used to determine if there was a difference between groups. A binary logistic regression was performed to determine the odds ratio (OR) and 95% confidence intervals. Results: The matched cohorts included 359 patients in the arthroplasty group (57.2±13.3 years, 56.8% male, 33.0±7.3 kg/m 2 ) and 359 patients in the arthrodesis group (57.4±13.9 years, 58.5% male, 32.7±7.9 kg/m 2 ). There was an increase in transfusions, UTI, and return to the operating room in the arthrodesis group compared to the arthroplasty group (1.95%, 0.28%, p=0.038; 1.11%, 0.00%, p=0.045, 3.90%, 1.11%, p=0.017). The multivariate regression revealed that length of hospital stay (OR = 1.157) and insulin dependent diabetes (OR = 6.043) had an increased risk of any adverse event. Conclusion: The overall rate of any adverse event for ankle arthroplasty or arthrodesis was relatively low at 4.18% in the 30-day postoperative period. There was no adverse event that reached statistical significance, that was more likely in the TAA group compared to the AA group. Identification of these complication rates after TAA and AA, along with patient risk factors for adverse events can assist surgeons and patients in their choice of treatment for AOA.