Association of Dementia With Total Ankle Arthroplasty and Ankle Arthrodesis Outcomes: A Short Report.

Foot & Ankle Orthopaedics Pub Date : 2026-07-15 eCollection Date: 2026-07-01 DOI:10.1177/24730114261461273

Devon Nixon, Brook I Martin, Hyunkyu Ko

{"title":"Association of Dementia With Total Ankle Arthroplasty and Ankle Arthrodesis Outcomes: A Short Report.","authors":"Devon Nixon, Brook I Martin, Hyunkyu Ko","doi":"10.1177/24730114261461273","DOIUrl":null,"url":null,"abstract":"Background: Foot and ankle surgeons evaluate older patients with ankle arthritis and dementia. In this report, we analyzed postoperative complications following ankle arthrodesis (AA) and total ankle arthroplasty (TAA), hypothesizing greater risk in patients with dementia.Methods: We conducted a retrospective cohort study using Medicare claims from 2016 to 2021, including beneficiaries aged ≥65 years who underwent TAA or AA. The primary independent variable was dementia, defined using the Charlson Comorbidity Index (CCI) dementia component based on International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes within 90 days before the index procedure. Outcomes included postoperative complications, all-cause readmissions, and mortality within 90 days and 12 months. Multivariable logistic regression models estimated adjusted differences in complication rates by dementia status.Results: Dementia was present in 0.56% of TAA patients (73 of 13 134) and 3.6% of AA patients (308 of 8519). With the numbers available, no significant differences could be detected with dementia in TAA using adjusted multivariable analyses, although 12-month readmissions were higher (P = .046). In contrast, among AA patients, dementia was associated with increased 90-day readmissions (P = .041) and higher 12-month mortality (P = .001), whereas other outcomes were not statistically significant.Conclusion: We found differences in postoperative outcomes, particularly readmissions and mortality, in patients with dementia following AA. Conversely, we found limited differences in patients with and without dementia undergoing TAA, which may reflect limited power to detect modest differences given the smaller number of dementia patients in the TAA cohort. Further research should explore how the severity of cognitive impairment influences decision making in ankle arthritis treatment.Level of evidence: Level III, retrospective cohort study.","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261461273"},"PeriodicalIF":0.0000,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373339/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & Ankle Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24730114261461273","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/7/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Foot and ankle surgeons evaluate older patients with ankle arthritis and dementia. In this report, we analyzed postoperative complications following ankle arthrodesis (AA) and total ankle arthroplasty (TAA), hypothesizing greater risk in patients with dementia.

Methods: We conducted a retrospective cohort study using Medicare claims from 2016 to 2021, including beneficiaries aged ≥65 years who underwent TAA or AA. The primary independent variable was dementia, defined using the Charlson Comorbidity Index (CCI) dementia component based on International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes within 90 days before the index procedure. Outcomes included postoperative complications, all-cause readmissions, and mortality within 90 days and 12 months. Multivariable logistic regression models estimated adjusted differences in complication rates by dementia status.

Results: Dementia was present in 0.56% of TAA patients (73 of 13 134) and 3.6% of AA patients (308 of 8519). With the numbers available, no significant differences could be detected with dementia in TAA using adjusted multivariable analyses, although 12-month readmissions were higher (P = .046). In contrast, among AA patients, dementia was associated with increased 90-day readmissions (P = .041) and higher 12-month mortality (P = .001), whereas other outcomes were not statistically significant.

Conclusion: We found differences in postoperative outcomes, particularly readmissions and mortality, in patients with dementia following AA. Conversely, we found limited differences in patients with and without dementia undergoing TAA, which may reflect limited power to detect modest differences given the smaller number of dementia patients in the TAA cohort. Further research should explore how the severity of cognitive impairment influences decision making in ankle arthritis treatment.

Level of evidence: Level III, retrospective cohort study.

查看原文本刊更多论文

痴呆与全踝关节置换术和踝关节融合术结果的关系：一个简短的报告。

背景：足部和踝关节外科医生评估老年踝关节关节炎和痴呆患者。在本报告中，我们分析了踝关节融合术（AA）和全踝关节置换术（TAA）的术后并发症，并假设痴呆患者的风险更大。方法：我们对2016年至2021年的医疗保险索赔进行了回顾性队列研究，包括年龄≥65岁接受TAA或AA的受益人。主要自变量为痴呆，使用基于国际疾病分类第十版（ICD-10）诊断代码的Charlson共病指数（CCI）痴呆成分在指数程序前90天内定义。结果包括术后并发症、全因再入院和90天和12个月内的死亡率。多变量logistic回归模型估计了痴呆状态下并发症发生率的调整差异。结果：13134例TAA患者中有73例存在痴呆，占0.56%；8519例AA患者中有308例存在痴呆，占3.6%。有了可用的数据，使用调整后的多变量分析，虽然12个月的再入院率更高，但TAA与痴呆之间没有显著差异（P = 0.046）。相比之下，在AA患者中，痴呆与90天再入院率增加（P = 0.041）和12个月死亡率增加（P = 0.041）相关。001)，而其他结果无统计学意义。结论：我们发现AA后痴呆患者的术后结局，特别是再入院率和死亡率存在差异。相反，我们发现接受TAA的痴呆患者和非痴呆患者差异有限，这可能反映了由于TAA队列中痴呆患者数量较少，检测适度差异的能力有限。进一步的研究应该探讨认知障碍的严重程度如何影响踝关节关节炎治疗的决策。证据等级：III级，回顾性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊