2015 ISAKOS Biennial Congress ePoster #104

Does Open Ankle Arthrodesis Lead to Higher Rates of Adjacent Joint Fusion? A Database Analysis

Khushdeep Vig, BS, New York, NY UNITED STATES
Christopher D. Murawski, MD, Pittsburgh, PA UNITED STATES
Ethan J. Fraser, MBBS, New York, NY UNITED STATES
Payal Desai, MPH, New York, NY UNITED STATES
Ian Savage-Elliott, BA, New York, NY UNITED STATES
John G. Kennedy, MD, FRCS, New York, NY UNITED STATES

Hospital for Special Surgery, New York, NY, USA

FDA Status Not Applicable

Summary: While open ankle arthrodesis is more commonly performed than arthroscopic arthrodesis, it is associated with a higher rate of subsequent adjacent joint arthrodesis.

Rate:

Abstract:

Purpose

The purpose of this study was to perform a database analysis of orthopedic patients in the United States who underwent ankle arthrodesis, as well as subsequent procedures, and report associated trends.

Methods

A PearlDiver Patient Record Database analysis (2005-2011) of patients who underwent ankle arthrodesis (arthroscopic or open), as well as subsequent midfoot or hindfoot procedures (e.g. midtarsal fusion, pantalar fusion, subtalar fusion) procedures was performed using Current Procedural Terminology (CPT) codes. PearlDiver is a publicly available, Health Insurance Portability and Accountability Act compliant national database compiled from a collection of the Medicare Standard Analytical Files (2005-2011) and the United Healthcare Orthopedic Dataset (2007-2011).

Results

In total, 8,397 cases of ankle arthrodesis were performed over the 7-year period of data. Of these cases, 7,258 were performed with an open technique, whereas 1,139 were performed arthroscopically. Patients who underwent arthroscopic ankle arthrodesis as the index procedure were less likely to undergo a subsequent midfoot or hindfoot fusion than those who underwent open ankle arthrodesis (OR=0.46; 95%CI (0.32-0.67); P<0.0001). The incidence of open ankle arthrodesis increased by 10.3% from 2007-2011 (P<0.001), whereas arthroscopic ankle arthrodesis did not show a significant change temporally.

Conclusion

While open ankle arthrodesis is more commonly performed than arthroscopic arthrodesis, it is associated with a higher rate of subsequent adjacent joint arthrodesis. The factors that may potentiate these subsequent procedures must be further investigated.