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. 2016 May 23;6(5):e011332.
doi: 10.1136/bmjopen-2016-011332.

Quality measures for total ankle replacement, 30-day readmission and reoperation rates within 1 year of surgery: a data linkage study using the NJR data set

Razi Zaidi  1 , Alexander J Macgregor  2 , Andy Goldberg  1
Affiliations

Quality measures for total ankle replacement, 30-day readmission and reoperation rates within 1 year of surgery: a data linkage study using the NJR data set

Razi Zaidi et al. BMJ Open. .

Abstract

Objective: To report on the rate of 30-day readmission and the rate of additional or revision surgery within 12 months following total ankle replacement (TAR).

Design: A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. These two databases were linked in a deterministic fashion. HES episodes 12 months following the index procedure were isolated and analysed. Logistic regression was used to model predictors of reoperation and revision for primary ankle replacement.

Participants: All patients who underwent primary and revision ankle replacements according to the NJR between February 2008 and February 2013.

Results: The rate of 30-day readmission following primary and revision ankle replacement was 2.2% and 1.3%, respectively. In the 12 months following primary and revision ankle replacements, the revision rate (where implants needed to be removed) was 1.2% with increased odds in those orthopaedic units preforming <20 ankle replacements per year and patients with a preoperative fixed equinus deformity. The reoperation other than revision (where implants were not removed) in the 12 months following primary and revision TARs was 6.6% and 9.3%, respectively. Rheumatoid arthritis, cemented prosthesis and high ASA grade significantly increased the odds of reoperation.

Conclusions: TAR has a 30-day readmission rate of 2.2%, which is similar to that of knee replacement but lower than that of total hip replacement. 6.6% of patients undergoing primary TAR require a reoperation within 12 months of the index procedure. Early revision rates are significantly higher in low-volume centres.

Keywords: ankle replacement; data linkage; national joint registry.

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Figures

Figure 1
Figure 1
Flow chart to illustrate the linkage process.
Figure 2
Figure 2
Frequency of use of ankle prosthesis brands in the UK.
Figure 3
Figure 3
Frequency of concurrent procedures performed with primary TAR. TAR, total ankle replacement.
Figure 4
Figure 4
Frequency of concurrent procedures performed with revision TAR. TAR, total ankle replacement.
See this image and copyright information in PMC

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