title: The demand incidence of symptomatic ankle osteoarthritis presenting to foot & ankle surgeons in the United Kingdom.
abstract: BACKGROUND
  Ankle arthritis is a cause of major disability; however reports in the literature on the incidence of ankle osteoarthritis are rare.
  
  
  OBJECTIVE
  To explore the methodological challenges in obtaining an incidence of ankle osteoarthritis and to estimate the incidence of symptomatic osteoarthritis presenting to Foot & Ankle specialists in the UK.
  
  
  METHODS
  We searched available national diagnosis databases and also sent out a questionnaire-based survey to all Consultant members of the British Orthopaedic Foot & Ankle Society (n=180).
  
  
  RESULTS
  123 completed survey questionnaires were returned (68%) with each surgeon seeing on average 160 cases of symptomatic ankle arthritis and performing on average 20 definitive procedures for end-stage ankle osteoarthritis per year. There are no internationally agreed diagnostic or treatment codes specific for ankle osteoarthritis.
  
  
  CONCLUSIONS
  There are an estimated 29,000 cases of symptomatic ankle osteoarthritis being referred to specialists in the UK, representing a demand incidence of 47.7 per 100,000. 3000 definitive operations to treat end stage ankle osteoarthritis take place in the UK annually. We recommend that specific codes pertaining to ankle arthritis and its treatment be included in any future revisions of the WHO International Classification of Diseases (ICD) and operative procedure coding systems.
authors.affiliation: UCL Institute of Orthopaedics & Musculoskeletal Science, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. Andy.goldberg@rnoh.nhs.uk
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Goldberg
authors.forename: Alex
authors.initials: A
authors.lastname: MacGregor
authors.forename: Jill
authors.initials: J
authors.lastname: Dawson
authors.forename: Dishan
authors.initials: D
authors.lastname: Singh
authors.forename: Nick
authors.initials: N
authors.lastname: Cullen
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sharp
authors.forename: Paul H
authors.initials: PH
authors.lastname: Cooke
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods / Q000706:statistics & numerical data; D058737:Arthroplasty, Replacement, Ankle / Q000706:statistics & numerical data; D016208:Databases, Factual; D006301:Health Services Needs and Demand; D006801:Humans; D015994:Incidence; D010003:Osteoarthritis / Q000453:epidemiology* / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology