title: Analysis of Total Ankle Arthroplasty Survival in the United States Using Multiple State Databases.
abstract: The aim of this study was to evaluate survivorship and risk factors for failure of total ankle arthroplasty (TAA) in the United States using large statewide, multipayer databases of inpatient discharges. TAA patients from 2005 to 2009 were identified from the Healthcare Cost and Utilization Project databases for 5 states (California, Florida, Nebraska, North Carolina, and Utah) and the New York Department of Health Statewide Planning and Research Cooperative System database. Patient demographics and clinical characteristics were extracted, and a multivariable logistic regression model was developed to assess risk factors for 90-day all-cause readmission and failure. Failure was defined as revision, arthrodesis, amputation, or implant removal. During the period of interest, 1545 patients received 1593 TAA. The coded etiology of arthritis was primary osteoarthritis (n = 854, 55.2%), posttraumatic arthritis (n = 466, 30.2%), rheumatoid arthritis (n = 129, 8.4%), and other (n = 96, 6.2%). The 5-year survival rate was 90.1%. Patients with a coded diagnosis of rheumatoid arthritis (odds ratio [OR] = 2.18; 95% confidence interval [CI] = 1.04-4.01) or who were readmitted within 90 days of TAA (OR = 3.41; 95% CI = 1.67-6.97) had significantly increased risk of failure. Risk factors for readmission were Charlson-Deyo Score ≥2 (OR = 3.05; 95% CI = 1.51-6.15) and increased length of stay during the arthroplasty (OR = 1.30; 95% CI = 1.16-1.47).
  
  
  METHODS
  Therapeutic, Level IV: Observational study.
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (JL)University Orthopaedic Surgeons, U.T. Medical Center, Knoxville, Tennessee (CMS)Hospital for Special Surgery, New York, New York (HTD, GCK, SJE) jeremymlamothe@gmail.com.
authors.forename: Jeremy
authors.initials: J
authors.lastname: LaMothe
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (JL)University Orthopaedic Surgeons, U.T. Medical Center, Knoxville, Tennessee (CMS)Hospital for Special Surgery, New York, New York (HTD, GCK, SJE).
authors.forename: Christine M
authors.initials: CM
authors.lastname: Seaworth
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (JL)University Orthopaedic Surgeons, U.T. Medical Center, Knoxville, Tennessee (CMS)Hospital for Special Surgery, New York, New York (HTD, GCK, SJE).
authors.forename: Huong T
authors.initials: HT
authors.lastname: Do
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (JL)University Orthopaedic Surgeons, U.T. Medical Center, Knoxville, Tennessee (CMS)Hospital for Special Surgery, New York, New York (HTD, GCK, SJE).
authors.forename: Grace C
authors.initials: GC
authors.lastname: Kunas
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (JL)University Orthopaedic Surgeons, U.T. Medical Center, Knoxville, Tennessee (CMS)Hospital for Special Surgery, New York, New York (HTD, GCK, SJE).
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Ellis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058737:Arthroplasty, Replacement, Ankle; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D014481:United States; D055815:Young Adult
keywords: HCUP; ankle arthritis; survivorship; total ankle arthroplasty