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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Time trends and risk factors for perioperative complications in total ankle arthroplasty: retrospective analysis using a national database in Japan

Authors: Takumi Matsumoto, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Naohiro Izawa, Tetsuro Yasui, Yuho Kadono, Sakae Tanaka

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

Total ankle arthroplasty (TAA) has become increasingly popular worldwide as an alternative to ankle arthrodesis for surgical treatment of end-stage ankle arthritis. The aim of this epidemiological study, using a national inpatient database in Japan, was to describe the volume, utilization, patient characteristics, and temporal trends regarding these procedures in Japan, and to identify the risk factors associated with perioperative adverse events in TAA.

Methods

This was a population-based, retrospective cohort study. We retrospectively identified 2775 patients in the Diagnosis Procedure Combination database who underwent ankle arthrodesis or TAA for ankle arthritis at 559 hospitals in Japan from 2007 to 2013. Information on sex, age, main diagnosis, use of blood transfusion, duration of anesthesia, length of hospital stay, in-hospital mortality, hospitalization costs, additional procedures after primary surgery, and use of negative pressure wound therapy was extracted. Multivariable logistic regression analysis was performed to analyze the effect of various factors on the incidence of perioperative adverse events in TAA, including additional procedure during hospitalization, negative pressure wound therapy, blood transfusion, and in-hospital death.

Results

We identified 465 patients who underwent TAA and 2310 patients who underwent ankle arthrodesis. There was no apparent increase in the proportion of TAAs performed during the survey period. Patients undergoing TAA tended to be older, female, and have rheumatoid arthritis compared with those undergoing ankle arthrodesis. Patients undergoing TAA had shorter length of stay, higher hospitalization costs, and more blood transfusions compared with those undergoing ankle arthrodesis. Lower hospital volume and shorter anesthesia time were associated with higher rates of adverse events after TAA.

Conclusions

Despite an increase in the popularity of TAA internationally, the number of TAAs performed remains low in Japan. Lower hospital volume and anesthesia time were associated with higher rates of perioperative adverse events after TAA.

Level of evidence

IV, Cross-sectional study
Literature
1.
Zaidi R, Cro S, Gurusamy K, Siva N, Macgregor A, Henricson A, Goldberg A. The outcome of total ankle replacement: a systematic review and meta-analysis. Bone Joint J. 2013;95-B(11):1500–7.CrossRefPubMed
2.
Singh JA, Ramachandran R. Time trends in totankle arthroplasty in the USA: a study of the National Inpatient Sample. Clin Rheumatol. 2016;35(1):239–45.CrossRefPubMed
3.
Pugely AJ, Lu X, Amendola A, Callaghan JJ, Martin CT, Cram P. Trends in the use of total ankle replacement and ankle arthrodesis in the United States Medicare population. Foot Ankle Int. 2014;35(3):207–15.CrossRefPubMed
4.
5.
Henricson A, Coster M, Carlsson A. The Swedish National Ankle Registry. Fuβ&Sprunggelenk. 2014;12:65–9.
6.
7.
Clement RC, Krynetskiy E, Parekh SG. The total ankle arthroplasty learning curve with third-generation implants: a single surgeon's experience. Foot Ankle Spec. 2013;6(4):263–70.CrossRefPubMed
8.
Haskell A, Mann RA. Perioperative complication rate of total ankle replacement is reduced by surgeon experience. Foot Ankle Int. 2004;25(5):283–9.CrossRefPubMed
9.
Henricson A, Skoog A, Carlsson A. The Swedish Ankle Arthroplasty Register: An analysis of 531 arthroplasties between 1993 and 2005. Acta Orthop. 2007;78(5):569–74.CrossRefPubMed
10.
Lee KB, Cho SG, Hur CI, Yoon TR. Perioperative complications of HINTEGRA total ankle replacement: our initial 50 cases. Foot Ankle Int. 2008;29(10):978–84.CrossRefPubMed
11.
Myerson MS, Mroczek K. Perioperative complications of total ankle arthroplasty. Foot Ankle Int. 2003;24(1):17–21.CrossRefPubMed
12.
Saltzman CL, Mann RA, Ahrens JE, Amendola A, Anderson RB, Berlet GC, Brodsky JW, Chou LB, Clanton TO, Deland JT, et al. Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int. 2009;30(7):579–96.CrossRefPubMed
13.
Skytta ET, Koivu H, Eskelinen A, Ikavalko M, Paavolainen P, Remes V. Total ankle replacement: a population-based study of 515 cases from the Finnish Arthroplasty Register. Acta Orthop. 2010;81(1):114–8.CrossRefPubMedPubMedCentral
14.
Nunley JA, Caputo AM, Easley ME, Cook C. Intermediate to long-term outcomes of the STAR Total Ankle Replacement: the patient perspective. J Bone Joint Surg Am. 2012;94(1):43–8.CrossRefPubMed
15.
Gadd RJ, Barwick TW, Paling E, Davies MB, Blundell CM. Assessment of a three-grade classification of complications in total ankle replacement. Foot Ankle Int. 2014;35(5):434–7.CrossRefPubMed
16.
Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, Saunders LD, Beck CA, Feasby TE, Ghali WA. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.CrossRefPubMed
17.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.CrossRefPubMed
18.
Pinar N, Vernet E, Bizot P, Brilhault J. Total ankle arthroplasty - total ankle arthroplasty in Western France: influence of volume on complications and clinical outcome. Orthop Traumatol Surg Res. 2012;98(4 Suppl):S26–30.CrossRefPubMed
19.
20.
Kostuj T, Preis M, Walther M, Aghayev E, Krummenauer F, Roder C. German Total Ankle Replacement Register of the German Foot and Ankle Society (D. A. F.) - presentation of design and reliability of the data as well as first results. Z Orthop Unfall. 2014;152(5):446–54.CrossRefPubMed
21.
22.
Raikin SM, Rasouli MR, Espandar R, Maltenfort MG. Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion. Foot Ankle Int. 2014;35(3):216–24.CrossRefPubMed
23.
Jiang JJ, Schipper ON, Whyte N, Koh JL, Toolan BC. Comparison of perioperative complications and hospitalization outcomes after ankle arthrodesis versus total ankle arthroplasty from 2002 to 2011. Foot Ankle Int. 2015;36(4):360–8.CrossRefPubMed
24.
Argenson JN, Boisgard S, Parratte S, Descamps S, Bercovy M, Bonnevialle P, Briard JL, Brilhault J, Chouteau J, Nizard R, et al. Survival analysis of total knee arthroplasty at a minimum 10 years' follow-up: a multicenter French nationwide study including 846 cases. Orthop Traumatol Surg Res. 2013;99(4):385–90.CrossRefPubMed
25.
SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89(10):2143–9.PubMed
26.
Daniels TR, Younger AS, Penner M, Wing K, Dryden PJ, Wong H, Glazebrook M. Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg Am. 2014;96(2):135–42.CrossRefPubMed
27.
28.
Kessler B, Sendi P, Graber P, Knupp M, Zwicky L, Hintermann B, Zimmerli W. Risk factors for periprosthetic ankle joint infection: a case–control study. J Bone Joint Surg Am. 2012;94(20):1871–6.CrossRefPubMed
29.
Greene KA, Wilde AH, Stulberg BN. Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. J Arthroplasty. 1991;6(4):321–5.CrossRefPubMed
30.
Jameson SS, Mason JM, Baker PN, Elson DW, Deehan DJ, Reed MR. The Impact of Body Mass Index on Patient Reported Outcome Measures (PROMs) and Complications Following Primary Hip Arthroplasty. J Arthroplasty. 2014;29(10):1889–98.CrossRefPubMed
31.
Jones RE, Russell RD, Huo MH. Wound healing in total joint replacement. Bone Joint J. 2014;95-B(11 Suppl A):144–7.
32.
Raikin SM, Kane J, Ciminiello ME. Risk factors for incision-healing complications following total ankle arthroplasty. J Bone Joint Surg Am. 2010;92(12):2150–5.CrossRefPubMed
33.
Whalen JL, Spelsberg SC, Murray P. Wound breakdown after total ankle arthroplasty. Foot Ankle Int. 2010;31(4):301–5.CrossRefPubMed
34.
Noelle S, Egidy CC, Cross MB, Gebauer M, Klauser W. Complication rates after total ankle arthroplasty in one hundred consecutive prostheses. Int Orthop. 2013;37(9):1789–94.CrossRefPubMedPubMedCentral
35.
Werner BC, Burrus MT, Looney AM, Park JS, Perumal V, Cooper MT. Obesity Is Associated With Increased Complications After Operative Management of End-Stage Ankle Arthritis. Foot Ankle Int. 2015;36(8):863–70.CrossRefPubMed
36.
Lampley A, Gross CE, Green CL, DeOrio JK, Easley M, Adams S, Nunley 2nd JA. Association of Cigarette Use and Complication Rates and Outcomes Following Total Ankle Arthroplasty. Foot Ankle Int. 2016 [Epub ahead of print].
37.
Reuver JM, Dayerizadeh N, Burger B, Elmans L, Hoelen M, Tulp N. Total ankle replacement outcome in low volume centers: short-term followup. Foot Ankle Int. 2010;31(12):1064–8.CrossRefPubMed
38.
Roukis TS, Prissel MA. Registry data trends of total ankle replacement use. J Foot Ankle Surg. 2013;52(6):728–35.CrossRefPubMed
Metadata
Title
Time trends and risk factors for perioperative complications in total ankle arthroplasty: retrospective analysis using a national database in Japan
Authors
Takumi Matsumoto
Hideo Yasunaga
Hiroki Matsui
Kiyohide Fushimi
Naohiro Izawa
Tetsuro Yasui
Yuho Kadono
Sakae Tanaka
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1299-x

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