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

BackgroundSurgical management of ankle osteoarthritis (AOA) includes Ankle Arthrodesis (AA) or Total Ankle Arthroplasty (TAA). 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.MethodsPatients who underwent TAA or AA from January 2010 to December 2020 were included in this analysis. Matched cohorts were created using 1:1 propensity score matching to match patients according to patient demographics. Independent sample t-tests and chi-square tests were used to determine whether there was a difference between groups. A binary logistic regression was performed to determine the odds ratio (OR) and 95% confidence intervals for any adverse event as related to patient demographics and comorbidities.ResultsThere were 2,053 TAA and 359 AA in the unmatched cohorts. The matched cohorts included 359 patients in each group. In the matched cohorts, there was an increase in transfusions, urinary tract infection (UTI), and return to the operating room in the arthrodesis group compared with the arthroplasty group (1.95%, 0.28%, P = .038; 1.11%, 0.00%, P = .045, 3.90%, 1.11%, P = .017). The logistic 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 for TAA or AA.ConclusionIdentification of complication rates and patient risk factors for adverse events after TAA and AA can assist surgeons and patients in their choice of treatment for AOA.Levels of Evidence:III (retrospective cohort study).