Risk of revision and other complications in total ankle arthroplasty do not differ by surgeon specialty: Analysis of the PearlDiver healthcare claims database from 2010 to 2023.

Abstract

Background: Total ankle arthroplasty (TAA) utilization has significantly increased in the US in recent years, and current studies examining surgeon specialty and TAA outcomes are limited.

Purpose: To explore the effect of surgeon specialty on long-term TAA survivorship and short-term postoperative complications STUDY DESIGN: Retrospective cohort study and time-to-event analysis METHODS: Using a large, national claims database (PearlDiver, Inc.) with more than 170 million patient files we examined the association of surgeon specialty (podiatric surgeon vs. other) on adverse patient outcomes from January 2010 to April 2023. Relevant covariates were adjusted for using multivariable Cox and logistic regression models.

Results: There were 16,485 people who underwent TAA for a cumulative rate of 9.7 per 100,000. Surgeon specialty was known for 13,514 TAA surgeries. There were 714 revisions corresponding to a revision rate of 0.053 (714/13,514) over the 13-year study period. Patients who underwent TAA by podiatric surgeons were no more likely to experience revision surgery than those undergoing TAA by other surgeon specialties (adjusted hazards ratio [HR] 0.84, 95 % CI 0.46 to 1.53, p = 0.57). Furthermore, the risk of readmission (adjusted odds ratio [OR] 1.0, 95 % CI 0.77 to 1.30), infection (adjusted OR 0.91, 95 % CI 0.77 to 1.07), and venous thromboembolism (adjusted OR 0.83, 95 % CI 0.61 to 1.09) within the first 90 days postoperatively did not differ among surgeon specialty.

Conclusion: This information may be of interest to third party payers, health administrators, and healthcare consumers.