ArticleJB & JS open access
Total Ankle Replacement Outcomes in Obese Patients with Minimum 10-Year Follow-Up.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Obesity rates continue to rise worldwide. Current evidence for total ankle replacement (TAR) in obese patients is conflicting, limited to short-term to mid-term follow-up. Therefore, the aim of this study was to assess long-term outcomes of obese versus nonobese TAR patients. Methods: This retrospective cohort study was undertaken at a quaternary institution. Groups were defined by body mass index (BMI) (kg/m Results: The study included 515 TARs in 482 patients (236 ankles obese, 279 ankles nonobese) with a mean age of 64 years and mean follow-up of 13.2 years. 310 TARs had minimum 10-year PROMs follow-up for analysis. No statistically significant differences in AOS pain/disability and SF-36 Physical Component Summary/Mental Component Summary changes scores (preoperative to latest follow-up) were observed between the 2 cohorts. Obese patients had statistically worse AOS disability scores preoperatively (p = 0.01), while disability levels were comparable postoperatively. Multivariable linear regression analysis revealed BMI ≥30 was not associated with poorer outcomes when adjusting for age, sex, implant, preoperative PROM score, follow-up duration, arthritis etiology, or diabetes. The number of patients undergoing secondary procedures and the number of secondary procedures required between cohorts were similar (34.4% obese TARs vs. 37.6% nonobese TARs). Conclusions: TARs can be successfully undertaken in obese patients with long-term improvement in PROMs and no significant increase in incidence of secondary procedures similar to their nonobese counterparts. These findings challenge the perception of obesity as a relative contraindication to TAR and support its use in appropriately selected obese patients. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.
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