Resident, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA.
Staff Epidemiologist, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA.
J Foot Ankle Surg. 2020 Mar-Apr;59(2):274-279. doi: 10.1053/j.jfas.2019.08.014.
Total ankle arthroplasty (TAA) use has increased during the past 20 years, whereas ankle arthrodesis (AAD) use has remained constant. The purpose of this study was to examine trends in TAA and AAD use in American Board of Orthopedic Surgery Part II candidates while considering the influence of fellowship training status on treatment of end-stage ankle arthritis. The American Board of Orthopedic Surgery Part II database was queried to identify all candidates who performed ≥1 TAA or AAD from examination years 2009 through 2018. Candidates were categorized by examination year and by self-reported fellowship training status. Descriptive statistical methods were used to report procedure volumes. Trends in use of TAA and AAD were examined by using log-modified regression analyses. From 2009through 2018, there was no significant change in TAA or AAD use among all candidates (p = .92, p = .20). Candidates reporting a foot and ankle fellowship trended toward increased use of TAA relative to AAD compared with non-foot and ankle fellowship candidates, but this failed to reach statistical significance (p = .06). The use of arthroscopic AAD increased over time (p < .01) among all candidates. TAA and AAD use did not change over the study period. Volume of TAA and AAD performed by early-career surgeons remains low. The findings in this study should serve as an important reference for orthopedic trainees, early-career surgeons, and orthopedic educators interested in optimizing training curriculum for surgical management of end-stage ankle arthritis.
全踝关节置换术（TAA）的应用在过去 20 年中有所增加，而踝关节融合术（AAD）的应用则保持不变。本研究的目的是在考虑 Fellowship 培训状态对终末期踝关节关节炎治疗影响的情况下，检查美国骨科医师学会骨科委员会第二部分候选人中 TAA 和 AAD 的使用趋势。通过查询美国骨科医师学会骨科委员会第二部分数据库，确定了所有在 2009 年至 2018 年期间进行了≥1 次 TAA 或 AAD 的候选人。根据考试年份和自我报告的 Fellowship 培训状态对候选人进行分类。使用描述性统计方法报告手术量。使用对数修正回归分析检查 TAA 和 AAD 使用的趋势。在 2009 年至 2018 年期间，所有候选人的 TAA 或 AAD 使用均无显著变化（p=0.92，p=0.20）。与非足部和踝关节 Fellowship 候选人相比，报告足部和踝关节 Fellowship 的候选人 TAA 的使用趋势呈增加趋势，而 AAD 的使用趋势呈减少趋势，但这并未达到统计学意义（p=0.06）。所有候选人中，关节镜辅助 AAD 的使用随时间推移而增加（p<0.01）。在研究期间，TAA 和 AAD 的使用没有变化。早期职业外科医生进行的 TAA 和 AAD 手术量仍然较低。本研究的结果应为对手术治疗终末期踝关节关节炎的培训课程感兴趣的骨科受训者、早期职业外科医生和骨科教育工作者提供重要参考。
