PMID- 29852755 OWN - NLM STAT- MEDLINE DCOM- 20190614 LR - 20200306 IS - 1944-7876 (Electronic) IS - 1071-1007 (Print) IS - 1071-1007 (Linking) VI - 39 IP - 9 DP - 2018 Sep TI - Frequency and Impact of Adverse Events in Patients Undergoing Surgery for End-Stage Ankle Arthritis. PG - 1028-1038 LID - 10.1177/1071100718776021 [doi] AB - BACKGROUND: This study summarized the frequency and functional impact of adverse events (AEs) that occur after surgery for end-stage ankle arthritis (ESAA) to inform decision making. METHODS: This was a multisite prospective cohort study to compare ankle arthroplasty to ankle arthrodesis in the treatment of ESAA among 6 participating sites. We compared the risk and impact of nonankle AEs and ankle-specific AEs versus no AEs controlling for potential confounding factors, including operative procedure using multinomial logistic regression. We estimated differences in postoperative functional outcomes by AE occurrence using linear mixed effects regression. Among 517 patients who had surgery for ankle arthritis and completed the full baseline assessment, follow-up scores were available in 494 (95%) patients. RESULTS: There were a total of 628 reported AEs (477 in the arthroplasty group and 151 in the arthrodesis group). These occurred in 261 (63%) arthroplasty patients and 67 (65%) arthrodesis patients. There were 50 (8%) ankle-specific AEs. The risk of an ankle-specific AE was slightly higher in the arthrodesis group versus the arthroplasty group, odds ratio (OR) 1.84, 95% confidence interval (CI, 0.85, 3.98). The OR for the risk of non-ankle-specific AE versus no AE was 0.96, 95% CI (0.57, 1.61) for those receiving arthrodesis compared to arthroplasty. Compared to patients with no AEs, those experiencing ankle-specific AEs had significantly less improvement in Foot and Ankle Ability Measure Sports and activities of daily living (ADL) subscores and worst pain outcomes; however, both groups improved significantly in all measures except mental health. CONCLUSIONS: Ankle-specific AEs were infrequent and only weakly associated with operative procedure. Although patients improved in all functional outcomes except mental health, regardless of AE occurrence, ankle-specific AEs negatively impacted patient improvement compared to those with no AEs or a nonankle AE. The logistical effort and cost of tracking nonankle AEs does not seem to be justified. LEVEL OF EVIDENCE: Level II, prospective comparative study. FAU - Norvell, Daniel C AU - Norvell DC AD - 1 Spectrum Research, Tacoma, WA, USA. FAU - Shofer, Jane B AU - Shofer JB AD - 2 VA Puget Sound Health Care System, Seattle, WA, USA. FAU - Hansen, Sigvard T AU - Hansen ST AD - 3 Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA. FAU - Davitt, James AU - Davitt J AD - 4 Orthopedic + Fracture Specialists, Portland, OR, USA. FAU - Anderson, John G AU - Anderson JG AD - 5 Orthopaedic Associates of Michigan, Grand Rapids, MI, USA. FAU - Bohay, Donald AU - Bohay D AD - 5 Orthopaedic Associates of Michigan, Grand Rapids, MI, USA. FAU - Coetzee, J Chris AU - Coetzee JC AD - 6 Twin Cities Orthopedics, Edina, MN, USA. FAU - Maskill, John AU - Maskill J AD - 5 Orthopaedic Associates of Michigan, Grand Rapids, MI, USA. FAU - Brage, Michael AU - Brage M AD - 3 Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA. FAU - Houghton, Michael AU - Houghton M AD - 7 Orthopaedic & Spine Center of the Rockies, Fort Collins, CO, USA. FAU - Ledoux, William R AU - Ledoux WR AD - 2 VA Puget Sound Health Care System, Seattle, WA, USA. AD - 3 Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA. AD - 8 Department of Mechanical Engineering, University of Washington, Seattle, WA, USA. FAU - Sangeorzan, Bruce J AU - Sangeorzan BJ AD - 2 VA Puget Sound Health Care System, Seattle, WA, USA. AD - 3 Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA. LA - eng GR - IK6 RX002970/RX/RRD VA/United States GR - R01 AR056316/AR/NIAMS NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20180531 PL - United States TA - Foot Ankle Int JT - Foot & ankle international JID - 9433869 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Ankle Joint/*surgery MH - Arthritis/*surgery MH - Arthrodesis/*adverse effects MH - Arthroplasty, Replacement, Ankle/*adverse effects MH - Female MH - Humans MH - Male MH - Middle Aged MH - Postoperative Complications/epidemiology MH - Prospective Studies MH - Treatment Outcome PMC - PMC6318122 MID - NIHMS961621 OTO - NOTNLM OT - adverse events OT - ankle arthritis OT - ankle arthrodesis OT - ankle replacement OT - clinical outcomes OT - complications EDAT- 2018/06/02 06:00 MHDA- 2019/06/15 06:00 PMCR- 2019/09/01 CRDT- 2018/06/02 06:00 PHST- 2018/06/02 06:00 [pubmed] PHST- 2019/06/15 06:00 [medline] PHST- 2018/06/02 06:00 [entrez] PHST- 2019/09/01 00:00 [pmc-release] AID - 10.1177/1071100718776021 [doi] PST - ppublish SO - Foot Ankle Int. 2018 Sep;39(9):1028-1038. doi: 10.1177/1071100718776021. Epub 2018 May 31.