Mahamid Assil, Laver Lior, Maman David, Abu Elhija Amir, Haj Yahya Mohammad, Haverkamp Daniel, Berkovich Yaron, Behrbalk Eyal
Department of Orthopedics, Hillel Yaffe Medical Center, Hadera 3810101, Israel.
Rappaport Faculty of Medicine, Technion University Hospital (Israel Institute of Technology), Haifa 3200003, Israel.
J Clin Med. 2025 Apr 23;14(9):2909. doi: 10.3390/jcm14092909.
End-stage ankle osteoarthritis (OA) severely limits function and quality of life. Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are key surgical interventions when conservative treatment fails. This study compares TAA and AA outcomes using a national dataset to inform patient-centered care. A retrospective analysis of 27,595 patients undergoing TAA or AA from 2016-2019 was conducted using the National Inpatient Sample. Propensity score matching addressed baseline differences. Primary OA was more prevalent in TAA (85.9%) than in AA (55.4%). TAA utilization rose from 73% to 78% ( < 0.0001), while AA declined. TAA patients were older (65.6 vs. 59.7 years), more often Medicare-insured, and predominantly Caucasian. AA patients had higher rates of comorbidities, including diabetes, obesity, lung disease, and mental disorders (all < 0.0001). TAA and AA cater to distinct patient profiles. TAA is increasingly favored and associated with lower immediate risks, though procedure choice should be individualized based on comorbidities and risk profiles. These insights support evidence-based decision-making in end-stage ankle OA management.
终末期踝关节骨关节炎（OA）严重限制了功能和生活质量。当保守治疗失败时，全踝关节置换术（TAA）和踝关节融合术（AA）是关键的手术干预措施。本研究使用全国数据集比较TAA和AA的治疗效果，以为以患者为中心的护理提供参考。利用全国住院患者样本对2016年至2019年期间接受TAA或AA治疗的27595例患者进行了回顾性分析。倾向评分匹配解决了基线差异问题。原发性OA在TAA组（85.9%）比在AA组（55.4%）中更为普遍。TAA的使用率从73%上升至78%（<0.0001），而AA的使用率则有所下降。TAA患者年龄更大（65.6岁对59.7岁），更多人有医疗保险，且主要为白种人。AA患者的合并症发生率更高，包括糖尿病、肥胖、肺部疾病和精神障碍（均<0.0001）。TAA和AA针对不同的患者群体。TAA越来越受到青睐，且与之相关的直接风险较低，不过手术选择应根据合并症和风险状况进行个体化。这些见解为终末期踝关节OA的管理提供了循证决策依据。
