Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2023-05-02DOI: 10.1177/19386400231168737
Kathy M McGurk, Daniel J Scott, Caroline Hoch, Federico G Usuelli, Andrew Hsu, Christopher E Gross
{"title":"Sex Differences in Patient-Reported Outcomes and Range of Motion After Total Ankle Arthroplasty.","authors":"Kathy M McGurk, Daniel J Scott, Caroline Hoch, Federico G Usuelli, Andrew Hsu, Christopher E Gross","doi":"10.1177/19386400231168737","DOIUrl":"10.1177/19386400231168737","url":null,"abstract":"<p><p>BackgroundAs the popularity of total ankle arthroplasty (TAA) increases, there is a growing need to examine the effects of sex on postoperative outcomes. This study compares patient-reported outcome measures and ankle range of motion (ROM) in the postoperative period, as stratified by sex.MethodsPatients who underwent TAA during 2013 to 2018 with a minimum follow-up of 2 years were included (N = 133). American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, Visual Analog Scale (VAS), and 12-Item Short-Form Survey (SF-12) were administered preoperatively and at 6 months, 1 year, and 2 years postoperatively. ROM was recorded at these same time points.ResultsPreoperatively and at 6 months postoperatively, the cohorts did not differ in any of the measured outcomes. At 1 year postoperatively, females had lower SF-12 Physical Composite Scores (female = 44.1, male = 47.1, P = .019) and less plantarflexion (female = 20.5 degrees, male = 23.5 degrees, P = .029). By 2 years postoperative, females had lower AOFAS scores (female = 80.3, male = 85.4, P = .040). A greater complication rate amongst the female cohort approached significance at 18.6% versus 9% for males (P = .124).DiscussionThese results support TAA as a reliable means of treating ankle arthritis in both sexes, despite important differences. Understanding these outcome differences is critical for effectively managing expectations and treating both female and male populations.Levels of Evidence:Level III: Retrospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"229-235"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2025-02-21DOI: 10.1177/19386400251318906
Haleigh M Hopper, Chase T Nelson, James R Satalich, Kevin A Wu, Albert T Anastasio, Conor N O'Neill, Tejas T Patel, Andrew E Hanselman, Karl M Schweitzer, Samuel Adams
{"title":"Short-term Adverse Events Following Ankle Arthroplasty and Ankle Arthrodesis: A Matched Analysis of Recent Nationally Representative Data.","authors":"Haleigh M Hopper, Chase T Nelson, James R Satalich, Kevin A Wu, Albert T Anastasio, Conor N O'Neill, Tejas T Patel, Andrew E Hanselman, Karl M Schweitzer, Samuel Adams","doi":"10.1177/19386400251318906","DOIUrl":"10.1177/19386400251318906","url":null,"abstract":"<p><p>BackgroundSurgical management of ankle osteoarthritis (AOA) includes Ankle Arthrodesis (AA) or Total Ankle Arthroplasty (TAA). The purpose of this study was to analyze data from the National Surgical Quality Improvement Project (NSQIP) to elucidate differences in outcomes between TAA and AA.MethodsPatients who underwent TAA or AA from January 2010 to December 2020 were included in this analysis. Matched cohorts were created using 1:1 propensity score matching to match patients according to patient demographics. Independent sample t-tests and chi-square tests were used to determine whether there was a difference between groups. A binary logistic regression was performed to determine the odds ratio (OR) and 95% confidence intervals for any adverse event as related to patient demographics and comorbidities.ResultsThere were 2,053 TAA and 359 AA in the unmatched cohorts. The matched cohorts included 359 patients in each group. In the matched cohorts, there was an increase in transfusions, urinary tract infection (UTI), and return to the operating room in the arthrodesis group compared with the arthroplasty group (1.95%, 0.28%, P = .038; 1.11%, 0.00%, P = .045, 3.90%, 1.11%, P = .017). The logistic regression revealed that length of hospital stay (OR = 1.157) and insulin-dependent diabetes (OR = 6.043) had an increased risk of any adverse event for TAA or AA.ConclusionIdentification of complication rates and patient risk factors for adverse events after TAA and AA can assist surgeons and patients in their choice of treatment for AOA.Levels of Evidence:III (retrospective cohort study).</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"319-329"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2024-09-20DOI: 10.1177/19386400241274551
Kevin A Wu, Albert T Anastasio, James K DeOrio, James A Nunley, Mark E Easley, Samuel B Adams
{"title":"Exploring Revision Total Ankle Arthroplasty Failures: A Comparison Between Failed and Successful Revision Cases.","authors":"Kevin A Wu, Albert T Anastasio, James K DeOrio, James A Nunley, Mark E Easley, Samuel B Adams","doi":"10.1177/19386400241274551","DOIUrl":"10.1177/19386400241274551","url":null,"abstract":"<p><p>This study assesses the comorbidities that are associated with failed revision total ankle arthroplasty (TAA) and explores the outcomes following a failed revision TAA. A retrospective analysis was conducted on a cohort of patients who underwent a revision TAA at a single institution from 2008 to 2022. Patients were identified as having revision failure if they required explantation, below-knee amputation (BKA), or a revision of either metal component. Statistical analysis was performed to identify any significant differences and summarize outcomes. The study included a total of 87 patients who underwent revision TAA with 12 patients who subsequently experienced revision failure. The revision TAA failure rate was 13.8%. There were higher rates of former smokers (58.3%; n = 7) and a history of diabetes (33.3%; n = 4) in the failure cohort, although these differences did not reach statistical significance. Limb salvage procedures were achieved in 11 cases (91.7%). Approaches for failed revision TAAs included arthrodesis (n = 5) with 2 isolated ankle arthrodesis (AA) and 3 tibio-talo-calcaneal (TTC) arthrodesis, an additional revision arthroplasty (n = 6), or amputation (n = 1). Ankle arthroplasty retention was successful in 6 cases (50.0%). Our results demonstrate that a second revision approach was chosen in half of the cases, underscoring its viability as a successful intervention according to patient preferences.<b>Level of Evidence:</b> III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"286-294"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2024-03-07DOI: 10.1177/19386400241233637
Isabel Shaffrey, Emily Teehan, Kristin Caolo, Scott Ellis, Jonathan Deland, Jensen Henry, Constantine Demetracopoulos
{"title":"Effects of Travel Distance on Complications and Outcomes in Total Ankle Arthroplasty.","authors":"Isabel Shaffrey, Emily Teehan, Kristin Caolo, Scott Ellis, Jonathan Deland, Jensen Henry, Constantine Demetracopoulos","doi":"10.1177/19386400241233637","DOIUrl":"10.1177/19386400241233637","url":null,"abstract":"<p><p>Owing to the last decade's increase in the number of total ankle arthroplasty (TAA) procedures performed annually, there is a concern that the disproportionate distribution of orthopaedic surgeons who regularly perform TAA may impact complications and/or patient satisfaction. This study examines patient-reported outcomes and complications in TAA patients who had to travel for surgery compared to those treated locally. This is a single-center retrospective review of 160 patients undergoing primary TAA between January 2016 and December 2018, with mean age 65 (range: 59-71) years, mean body mass index (BMI) 28.7 kg/m<sup>2</sup>, 69 (43.1%) females, and mean 1.5 (SD = 0.51) years follow-up. Patients were grouped by distance traveled (<50 miles [n = 89] versus >50 miles traveled [n = 71]). There were no significant differences in rate or type of postoperative complications between the <50 mile group (16.9%) and the >50 mile group (22.5%) (P = .277). Similarly, there were no significant difference in postoperative PROMIS scores between the groups (P = .858). Given uneven distribution of high-volume surgeons performing TAA, this is important for patients who are deciding where to have their TAA surgery and for surgeons on how to counsel patients regarding risks when traveling longer distances for TAA care.Levels of Evidence: <i>Level III: Retrospective Cohort Study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"279-285"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2024-10-03DOI: 10.1177/19386400241274262
Joseph R Brown, Zachary P Hill, Ross Groeschl, Brian Steginsky, Robert W Mendicino
{"title":"Effects of Parallax and Distortion in Total Ankle Arthroplasty.","authors":"Joseph R Brown, Zachary P Hill, Ross Groeschl, Brian Steginsky, Robert W Mendicino","doi":"10.1177/19386400241274262","DOIUrl":"10.1177/19386400241274262","url":null,"abstract":"<p><p>BackgroundSurgeons rely on intraoperative fluoroscopy to assist in placement of implant components during total ankle arthroplasty (TAA). Parallax alters the direction of an object when viewed from two different points, resulting in image distortion. The purpose of this study was to evaluate parallax/distortion in intraoperative fluoroscopic images during TAA.MethodsA retrospective review of all TAAs performed by two surgeons (R.W.M. and B.S.) from August 2019 to April 2023 were reviewed. Intraoperative fluoroscopic anteroposterior (AP) ankle views were evaluated for any obvious parallax image distortion. Cases with obvious parallax distortion were included for angular evaluation of AP intraoperative fluoroscopic and first postoperative plain films. The tibia was marked at 2-centimeter intervals to create zones from the proximal stem of the implant. The anatomical axis of the tibia (AAT) was drawn at the mid-diaphysis. The anatomic lateral distal tibial angle (aLDTA) and anatomic axis deviation (AAD) were measured for each zone.ResultsA total of 22 TAAs were performed during the study period. Four cases were excluded due to inadequate imaging, leaving a total of 18 TAAs for review. We found 6 of 18 (33.3%) cases had obvious parallax distortion. We found the average aLDTA was 90.9° (84°-101°). At the most proximal tibial zone, the average aLDTA was 94° (91°-101°). We found the average AAD was 4.7 (0.5-17.2) mm. The AAD ranged from 0.5 to 17.2 mm lateral to 0.8 to 8.2 mm medial. Postoperative plain film radiographs displayed a normal aLDTA and an AAT centered within the ankle joint.ConclusionParallax can distort the appearance of the tibia on fluoroscopic images. Deviation from the normal aLDTA and anatomical axis should be anticipated. Surgeons should be aware of the potential impact of parallax and ways to mitigate these effects.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"305-310"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2023-12-11DOI: 10.1177/19386400231216330
Albert T Anastasio, Kempland C Walley, Billy I Kim, Mikhail A Bethell, Samuel B Adams
{"title":"Nationally Representative Trends in Incidence of Procedures Done Concomitantly With Primary and Revision Total Ankle From 2012 to 2020.","authors":"Albert T Anastasio, Kempland C Walley, Billy I Kim, Mikhail A Bethell, Samuel B Adams","doi":"10.1177/19386400231216330","DOIUrl":"10.1177/19386400231216330","url":null,"abstract":"<p><p>BackgroundAs new literature emerges and practice patterns fluctuate, there is a significant potential for variation with regard to adjunctive procedures performed with primary total ankle arthroplasty (pTAA) and revision total ankle arthroplasty (rTAA). Our study aims to evaluate yearly trends in the incidence of concomitant procedures and compare the incidence of adjunctive procedures between pTAA and rTAA.MethodsThe 2012-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all pTAA and rTAA. The number of concurrent procedures was compared between pTAA and rTAA and compared across years available in the most current version of the NSQIP database (2012-2020).ResultsPatients undergoing pTAA had a higher mean age than patients undergoing rTAA (64 vs 61 years; P < .001), and patients undergoing rTAA had higher wound class (P < .001), indicating higher levels of contamination. Concurrent procedures were performed significantly less frequently with pTAA than rTAA (mean procedures 0.82 vs 1.30; P < .001). Removal of deep implants was more commonly coded with rTAA than pTAA (9.0% vs 17.7%; P < .001). Gastrocnemius recession was more frequently performed with pTAA than rTAA (10.4% vs 3.0%; P = .001).ConclusionAs pTAA and rTAA increase in incidence throughout the United States, there is increased importance on furthering our understanding of these procedures. This study provides a nationally representative analysis of adjunctive procedures with pTAA and rTAA from 2012 to 2020. Generally, more adjunctive procedures are performed with rTAA versus pTAA, confirming the high complexity of rTAA.Levels of Evidence:Level III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"269-278"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2024-09-23DOI: 10.1177/19386400241280357
Zachary P Hill, Joseph R Brown, Daniel DeGenova, Benjamin C Taylor, Robert Mendicino, Isaac Korb
{"title":"Traumatic Periprosthetic Fractures Following Total Ankle Replacement: A Systematic Review and Proposed Classification.","authors":"Zachary P Hill, Joseph R Brown, Daniel DeGenova, Benjamin C Taylor, Robert Mendicino, Isaac Korb","doi":"10.1177/19386400241280357","DOIUrl":"10.1177/19386400241280357","url":null,"abstract":"<p><p>Total ankle replacements (TAR) are increasingly utilized, but postoperative traumatic periprosthetic fractures remain a rare yet challenging complication. This systematic review aims to address the gap in literature by proposing a comprehensive classification system for these fractures, considering implant stability, fracture location, and surrounding bone quality. A systematic review identified 13 cases from 9 studies meeting inclusion criteria. Fractures were categorized using the proposed Hill-Brown classification: Type A (talus or fibula), Type B (distal tibial component), and Type C (diaphysis/proximal tibial metaphysis). Implant stability was a key factor, with Type B fractures further classified as B1 (stable), B2 (unstable with adequate bone stock), and B3 (unstable with poor bone stock). Most fractures occurred at or near the distal tibial component (Type B), with implant stability largely dependent on fracture location and bone quality. Surgical fixation, particularly minimally invasive plate osteosynthesis (MIPO) with locking plates, was the preferred treatment for stable implants, showing low complication rates. Unstable implants often required revision TAR or conversion to arthrodesis. Surgical intervention is recommended following all traumatic periprosthetic fractures in the setting of a TAR. Bone quality, particularly in patients with rheumatoid arthritis or osteoporosis, significantly impacted treatment decisions. Our findings emphasize the importance of fracture location, implant stability, and bone quality in managing these fractures. Future multicenter studies are necessary to validate this classification system and refine treatment protocols.<b>Level of Evidence:</b> Level III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"295-304"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2025-01-07DOI: 10.1177/19386400241310695
Lauren M Christie, Terrence M Philbin
{"title":"Early Experience With the Quantum Total Ankle Prosthesis.","authors":"Lauren M Christie, Terrence M Philbin","doi":"10.1177/19386400241310695","DOIUrl":"10.1177/19386400241310695","url":null,"abstract":"<p><p>The Quantum total ankle prosthesis is a newer Food and Drug Administration (FDA)-approved fourth-generation 2-component, fixed-bearing implant in its first-generation design. The purpose of this study was to evaluate early outcome data and present our initial experience with the Quantum implant with a minimum of a 1-year follow-up. A retrospective, single-centered chart and radiographic review was performed on all patients who underwent total ankle arthroplasty with the Quantum implant from December 2021 to August 2023. Implant survivorship, radiographic outcomes, clinical outcomes, and complications were evaluated. The survivorship for the implant was 100% for the tibial component and 91.67% for the talar component, respectively. Pre-operatively, there were 3 ankles with a coronal deformity greater than 10 degrees. Post-operatively, coronal plane deformity was 100% corrected into neutral alignment. This study is the first to report on short-term outcomes for the Quantum total ankle prosthesis. Our findings showed promising results of short-term implant survivorship with good clinical and radiographic outcomes.<b>Level of Evidence:</b> IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"311-318"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2023-05-06DOI: 10.1177/19386400231169368
Lauren K Lewis, Daniel C Jupiter, Vinod K Panchbhavi, Jie Chen
{"title":"Five-Factor Modified Frailty Index as a Predictor of Complications Following Total Ankle Arthroplasty.","authors":"Lauren K Lewis, Daniel C Jupiter, Vinod K Panchbhavi, Jie Chen","doi":"10.1177/19386400231169368","DOIUrl":"10.1177/19386400231169368","url":null,"abstract":"<p><p>IntroductionAnkle arthritis adversely affects patients' function and quality of life. Treatment options for end-stage ankle arthritis include total ankle arthroplasty (TAA). A 5-item modified frailty index (mFI-5) has predicted adverse outcomes following multiple orthopaedic procedures; this study evaluated its suitability as a risk-stratification tool in patients undergoing TAA.MethodsThe National Surgical Quality Improvement Program (NSQIP) database was retrospectively reviewed for patients undergoing TAA between 2011 and 2017. Bivariate and multivariate statistical analyses were performed to investigate frailty as a possible predictor of postoperative complications.ResultsIn total, 1035 patients were identified. When comparing patients with an mFI-5 score of 0 versus ≥2, overall complication rates significantly increased from 5.24% to 19.38%, 30-day readmission rate increased from 0.24% to 3.1%, adverse discharge rate increased from 3.81% to 15.5%, and wound complications increased from 0.24% to 1.55%. After multivariate analysis, mFI-5 score remained significantly associated with patients' risk of developing any complication (P = .03) and 30-day readmission rate (P = .005).ConclusionsFrailty is associated with adverse outcomes following TAA. The mFI-5 can help identify patients who are at an elevated risk of sustaining a complication, allowing for improved decision-making and perioperative care when considering TAA.Levels of Evidence:III, Prognostic.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"236-243"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9418933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot & ankle specialistPub Date : 2025-06-01Epub Date: 2023-05-11DOI: 10.1177/19386400231169367
Theodore Quan, Matthew Magruder, Frank R Chen, Sean Tabaie, Matthew J Best, Amiethab Aiyer
{"title":"Preoperative Dehydration Increases the Risk of Extended Length of Hospital Stay Following Total Ankle Arthroplasty.","authors":"Theodore Quan, Matthew Magruder, Frank R Chen, Sean Tabaie, Matthew J Best, Amiethab Aiyer","doi":"10.1177/19386400231169367","DOIUrl":"10.1177/19386400231169367","url":null,"abstract":"<p><p>IntroductionThe effects of preoperative dehydration on outcomes following total ankle arthroplasty (TAA) remain unknown. Therefore, the purpose of this study is to evaluate the association between dehydration and postoperative complications for patients undergoing TAA.MethodsPatients undergoing TAA from 2007 to 2019 were identified in the National Surgical Quality Improvement Program (NSQIP) database. A preoperative serum blood urea nitrogen/creatinine (BUN/Cr) greater than 20 was used to define preoperative dehydration. Patients were stratified into 2 cohorts: patients who were dehydrated (BUN/Cr > 20) and patients without dehydration (BUN/Cr ≤ 20). In this analysis, various postoperative outcomes were assessed with bivariate and multivariate analyses.ResultsIn total, 1033 patients underwent TAA and had their serum BUN and Cr values recorded. For both BUN and Cr, the patients in this study had their serum values recorded a mean of 15 days before their surgery. A total of 588 patients (56.9%) did not have dehydration preoperatively and 445 patients (43.1%) were dehydrated. Following adjustment on multivariate analysis, an increased risk of extended length of hospital stay (odds ratio [OR] = 1.457; p = 0.024) was seen in the dehydrated group compared with those who were noted to be well hydrated.ConclusionAs fluid intake is one modifiable preoperative variable that can be easily monitored during elective procedures, it is important for physicians to be aware of patients who are dehydrated and adjust their fluids appropriately to optimize postoperative outcomes.Levels of Evidence:Level III: Retrospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"244-250"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9443087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}