Differences in the 30 Days vs One-Year Complications and Reoperations after Total Ankle Replacement and Ankle Arthrodesis: A Large Database Study

Abstract

Category: Ankle; Ankle Arthritis Introduction/Purpose: Total ankle replacement (TAR) and Ankle arthrodesis (AA) are two commonly performed procedures for end stage arthritis of ankle joint. Aim of this study was to analyze the characteristics of the complications and reoperations at 30 days and 1 year in a matched sample of TAR and AA in a large database population Methods: Commercially available patient database record (PearlDiver) was used for this study. Patient undergoing TAR and AA were identified using CPT code. After matching two groups for diabetes, smoking, obesity and comorbidities scores, the differences in the risk of complications at 30 days and 1 year and the risk of reoperation at 1 year were noted in both groups. Results: There were 1287 patients in each matched group. Four hundred and thirty patients were diabetic, 102 patients were smokers and 543 patients were obese. The risk of surgical site infection and wound dehiscence were higher at 30 days in the AA group. Vast majority of observed complications (More than 50% of complications) happened after 30 days. AA group showed higher risk of SSI, wound dehiscence, mechanical complications and pneumonia at 1 year. The risk of reoperation was also higher in the AA group at 1 year. Conclusion: Ankle arthrodesis is associated with higher risk of local and systemic complications at 30 days and 1 years and higher reoperation rate at 1 year. Most complications happened after 30 days which highlights the fact that studies reporting 30 days complications after AA and TAR may underestimate the complications.