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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Amputation risk after total ankle arthroplasty: A national database study with verified continued patient enrollment
Jean G Louka1, Eslam Alkaramany2, Nacime S Mansur1
1Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, United States.
Background:
Total ankle arthroplasty (TAA) is increasingly common, but risk of amputation after TAA is poorly defined.
Methods:
Patients who underwent TAA between 2010 and 2018 and were verified to be continuously enrolled in a commercial insurance database for 5 subsequent years were evaluated for subsequent lower extremity amputation.
Results:
A total of 6439 patients underwent primary TAA; 2134 (33.2%) had diabetes. Over 5 years, 39 major amputations occurred (0.60%). Patients with diabetes had a significantly higher risk of amputation than those without diabetes (0.98% vs 0.42%; RR 2.35 [95% CI 1.26-4.40]; p = 0.0095).
Conclusions:
In this study, the 5-year rate of major amputation following primary TAA was 0.60% overall. The rate was 0.98% in diabetic patients, significantly higher than that in non-diabetic patients. Careful patient selection and optimization of glycemic control remain essential when considering total ankle arthroplasty.
