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Emergency Department Utilization Following Primary Versus Revision Ankle Arthrodesis: A Propensity-Matched Analysis
Trenton Pritt1, Akhil Bolisetti1, George Yacoub1
1Penn State College of Medicine, Hershey, Pennsylvania, USA.
Summary
Revision ankle arthrodesis (AA) showed lower emergency department (ED) utilization within one year compared to primary AA. This study found revision AA is not associated with increased postoperative healthcare needs.
Area of Science:
- Orthopedic surgery
- Healthcare outcomes research
Background:
- Revision ankle arthrodesis (AA) is perceived as more complex than primary AA.
- Emergency department (ED) utilization is a key metric for postoperative outcomes.
- Limited data exists comparing ED utilization between primary and revision AA.
Purpose of the Study:
- To compare 1-year postoperative ED utilization after primary versus revision ankle arthrodesis.
- To assess if revision AA leads to higher healthcare utilization post-surgery.
Main Methods:
- Retrospective comparative cohort study of patients undergoing AA from 2015-2025.
- Propensity score matching (1:1) to control for patient covariates.
- Evaluation of ED visits within 1 year postoperatively.
Main Results:
- 32.4% of primary AA patients had ED utilization vs. 8.8% of revision AA patients.
- Revision AA was associated with significantly lower ED utilization (RR 0.27, OR 0.20).
- Infection was the primary reason for ED presentation in both groups.
Conclusions:
- Revision AA did not show increased postoperative ED utilization in this matched analysis.
- Revision AA demonstrated lower ED utilization compared to primary AA.
- Infection remains the leading cause for postoperative ED visits.