Association of Ankle Arthritis Score With Need for Revision Surgery

Area of Science:

• Orthopedic Surgery
• Biostatistics
• Patient-Reported Outcomes

Background:

• The Ankle Arthritis Score (AAS) is a novel patient-reported outcome measure derived from the Ankle Osteoarthritis Scale (AOS).
• This study utilizes data from the Canadian Orthopaedic Foot and Ankle Society (COFAS) Ankle Arthritis Study cohort.

Purpose of the Study:

• To evaluate the association between postoperative Ankle Arthritis Scores (AAS) and the requirement for revision surgery following ankle reconstruction.
• To assess the predictive value of the AAS in identifying patients at higher risk for revision surgery after total ankle replacement (TAR) and ankle arthrodesis (AA).

Main Methods:

• A multicenter, prospective, ankle reconstruction study included 653 ankles undergoing TAR or AA.
• The AAS was administered at baseline and annually postoperatively.
• Time to revision surgery was analyzed using a proportional hazards model, with a final sample of 531 ankles.

Main Results:

• Revision surgery was performed in 62 ankles for metal-component issues and 8 for arthrodesis.
• Higher postoperative AAS scores and longer follow-up duration were significantly associated with revision surgery after TAR.
• Each 1-point increase in AAS correlated with a 1% higher rate of revision surgery after TAR.

Conclusions:

• Patients undergoing TAR with higher postoperative AAS scores, indicating greater functional impairment, face a higher probability of requiring revision surgery.
• The risk of revision surgery after TAR increases with the length of follow-up, even after adjusting for other patient factors.
• The Ankle Arthritis Score (AAS) demonstrates utility as a clinical tool for predicting revision surgery needs in ankle arthritis patients.