Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
Foot Ankle Int. 2024 Jun;45(6):567-573. doi: 10.1177/10711007241241071. Epub 2024 May 7.
Prior literature has demonstrated that ipsilateral hindfoot arthrodesis may increase the risk for reoperation after total ankle arthroplasty (TAA) and that simultaneous hindfoot arthrodesis with TAA could result in short-term clinical and radiologic improvements. The purpose of this study is to compare the reoperation rates after TAA with prior hindfoot arthrodesis vs simultaneous arthrodesis and TAA.
Patients who underwent primary TAA were identified in the PearlDiver database. Patients were sorted into 2 study cohorts: hindfoot arthrodesis prior to TAA and simultaneous arthrodesis and TAA. Propensity matched control cohorts were identified for each study group. Multivariate analysis was conducted to account for any confounding variables and covariates when identifying differences in complications between cohorts.
297 patients underwent TAA with prior hindfoot arthrodesis and 174 underwent TAA and hindfoot arthrodesis concurrently. The incidence of reoperation (13.8% vs 5.2%, .001) and infection (12.6% vs 5.9%, .011) for the simultaneous cohort was higher when compared to the matched control cohort. In contrast, there was no statistically significant difference when comparing the prior arthrodesis cohort to the matched control cohort in reoperation rates (5.1% vs 4.7%, .787) or infection rates (4.4% vs 4.8%, .734). Those undergoing simultaneous procedures had increased incidences of reoperation, wound complications, infection, and emergency department visits ( .0167) when compared to the TAA with prior arthrodesis cohort.
Patients undergoing TAA and hindfoot arthrodesis concurrently were found to have higher rates of reoperation and infection when compared to the matched control cohort . In contrast, there was no difference in these rates in patients undergoing TAA with prior hindfoot arthrodesis compared with their matched control cohort. Patients undergoing simultaneous procedures had increased rates of reoperations, wound complications, infection, and emergency department visits compared to the TAA with prior arthrodesis cohort.
先前的文献已经证明，同侧后足关节融合术可能会增加全踝关节置换术（TAA）后的再次手术风险，而 TAA 同期进行后足关节融合术可能会带来短期的临床和影像学改善。本研究的目的是比较 TAA 后行既往后足关节融合术与同期行关节融合术和 TAA 的再手术率。
在 PearlDiver 数据库中确定接受初次 TAA 的患者。患者被分为两组研究队列：TAA 前行后足关节融合术和同期行关节融合术和 TAA。为每组研究队列确定了倾向匹配的对照组。当确定队列之间并发症差异时，进行多变量分析以考虑任何混杂变量和协变量。
297 例患者行 TAA 前行后足关节融合术，174 例行 TAA 同期行后足关节融合术。同期组的再手术率（13.8%比 5.2%，P<.001）和感染率（12.6%比 5.9%，P=.011）高于匹配对照组。相比之下，与匹配对照组相比，既往关节融合术组的再手术率（5.1%比 4.7%，P=.787）或感染率（4.4%比 4.8%，P=.734）没有统计学意义。与 TAA 前行关节融合术组相比，同期行手术的患者再手术、伤口并发症、感染和急诊就诊的发生率更高（P<.0167）。
与匹配对照组相比，行 TAA 同期后足关节融合术的患者再手术和感染率更高。相比之下，行 TAA 前行后足关节融合术的患者与匹配对照组相比，这些比率没有差异。与 TAA 前行关节融合术组相比，同期行手术的患者再手术、伤口并发症、感染和急诊就诊的发生率更高。
