Sambandam Senthil, Serbin Philip, Riepen Dietrich, Aggarwal Vikram A, Mounasamy Varatharaj, Wukich Dane
Orthopedics, University of Texas Southwestern Medical Center, Dallas, USA.
Cureus. 2022 Sep 2;14(9):e28703. doi: 10.7759/cureus.28703. eCollection 2022 Sep.
Purpose Total ankle replacement (TAR) and ankle arthrodesis (AA) are two commonly performed procedures for end-stage arthritis of the ankle joint. The aim of this study was to analyze the differences in the rates of complications and reoperations at both 30 days and one year within a matched sample of TAR and AA patients from a large database population. Methods A commercially available patient database record, known as the PearlDiver database (www.pearldiverinc.com, Colorado Springs, CO, USA), was used for this study. Patients undergoing TAR and AA were identified using Current Procedural Terminology (CPT) codes. After matching both TAR and AA groups for confounding variables, such as diabetes, smoking, obesity, and comorbidities scores, the differences in the rates of complications at 30 days and one year and the rate of reoperation at one year were evaluated in both groups. Results After matching for confounding variables, there were 1287 patients in each group. There was no significant difference in the male/female ratio. Within each group, 430 patients were diabetic, 102 patients smoked, and 543 patients were obese. The rate of surgical site infection (SSI) and wound dehiscence were higher at 30 days in the AA group. About 63.45% of complications happened after 30 days. The AA group showed a higher rate of SSI, wound dehiscence, mechanical complications, and pneumonia at one year. The rate of reoperation was also higher in the AA group at one year. Conclusion Ankle arthrodesis is associated with a higher rate of local and systemic complications at 30 days and one year, along with a higher reoperation rate at one year, when compared to total ankle replacement. Most complications happened after 30 days, suggesting that studies reporting complications within 30 days following AA and TAR may underestimate the true rates of complications.
目的 全踝关节置换术（TAR）和踝关节融合术（AA）是踝关节终末期关节炎两种常见的手术方式。本研究旨在分析来自大型数据库人群的TAR和AA患者匹配样本在30天和1年时并发症发生率及再次手术率的差异。方法 本研究使用了一个名为PearlDiver数据库（www.pearldiverinc.com，美国科罗拉多州科泉市）的商业可用患者数据库记录。通过现行程序编码术语（CPT）识别接受TAR和AA的患者。在对TAR组和AA组的混杂变量（如糖尿病、吸烟、肥胖和合并症评分）进行匹配后，评估两组在30天和1年时的并发症发生率差异以及1年时的再次手术率。结果 在对混杂变量进行匹配后，每组有1287例患者。男女比例无显著差异。每组中有430例糖尿病患者、102例吸烟者和543例肥胖患者。AA组在30天时手术部位感染（SSI）和伤口裂开的发生率较高。约63.45%的并发症发生在30天之后。AA组在1年时SSI、伤口裂开、机械并发症和肺炎的发生率较高。AA组在1年时的再次手术率也较高。结论 与全踝关节置换术相比，踝关节融合术在30天和1年时局部和全身并发症发生率较高，1年时再次手术率也较高。大多数并发症发生在30天之后，这表明报告AA和TAR术后30天内并发症的研究可能低估了真实的并发症发生率。
