Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 14;7(2):24730114221102456.
doi: 10.1177/24730114221102456. eCollection 2022 Apr.

Factors Predictive of Early Complications Following Total Ankle Arthroplasty

Christopher Del Balso  1 , Mansur M Halai  2 , Mark D MacLeod  1 , David W Sanders  1 , Abdel Rahman Lawendy  1
Affiliations

Factors Predictive of Early Complications Following Total Ankle Arthroplasty

Christopher Del Balso et al. Foot Ankle Orthop. .

Abstract

Background: The safety of outpatient total ankle arthroplasty (TAA), and factors predictive of early complications are poorly understood. The objective of this study was to determine the frequency of early complications in patients undergoing outpatient TAA compared to a matched inpatient TAA cohort. Factors predictive of early complications following TAA are elucidated.

Methods: A retrospective review of prospectively collected data from the 2011-2018 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was performed. An unadjusted analysis comparing complication rates in outpatient, and inpatient TAA was performed followed by a propensity score-matched cohort analysis. A multivariate logistic regression model was then used to identify significant independent predictors for complications, reoperation, and readmission following TAA.

Results: A total of 1487 patients (198 outpatient, 1289 inpatient) undergoing TAA were included in the study. Inpatient TAA was associated with increased 30-day readmission compared with outpatient TAA (3.54% vs 0.51%, P = .032) in a matched cohort analysis. Thirty-eight (2.6%) patients had a minor complication, with 16 (1.1%) patients having a major complication after TAR. Nineteen (1.3%) patients underwent reoperation, and 42 (2.8%) patients were readmitted within 30 days of the index TAR. Multivariate analysis identified factors predictive of early complications to include length of stay (LOS) >2 days, smoking, hypertension, bleeding disorders, and diabetes mellitus.

Conclusion: From this relatively limited data set, outpatient TAA appears to be safe for management of end-stage ankle arthritis in select patients. Inpatient status was associated with an increased rate of 30-day readmission following TAA. Postoperative length of stay >2 days, smoking, hypertension, bleeding disorders, and diabetes mellitus were identified to be associated with early postoperative complications following TAA in this cohort.

Level of evidence: Level III, retrospective cohort study.

Keywords: complications; outpatient; readmission; reoperation; total ankle arthroplasty.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

References

    1. Akoh CC, Fletcher AN, Chen J, et al.. Economic analysis and clinical outcomes of short-stay versus inpatient total ankle replacement surgery. Foot Ankle Int. 2021;42(1):96-106. doi:10.1177/1071100720949200 - DOI - PubMed
    1. Al-Bashaireh AM, Haddad LG, Weaver M, Kelly DL, Chengguo X, Yoon S. The effect of tobacco smoking on musculoskeletal health: a systematic review. J Environ Public Health. 2018;2018:4184190. doi:10.1155/2018/4184190 - DOI - PMC - PubMed
    1. American College of Surgeons National Surgical Quality Improvement Program. Participant User File (PUF) User Guide. American College of Surgeons National Surgical Quality Improvement Program; 2016.
    1. Barg A, Elsner A, Hefti D, Hintermann B. Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series. Haemophilia. 2010;16(4):647-655. doi:10.1111/j.1365-2516.2010.02221.x - DOI - PubMed
    1. Barg K, Wiewiorski M, Anderson AE, et al.. Total ankle replacement in patients with von Willebrand disease: mid-term results of 18 procedures. Haemophilia. 2015;21(5):e389-e401. doi:10.1111/hae.12561 - DOI - PubMed