Amputation risk after total ankle arthroplasty: A national database study with verified continued patient enrollment.

BACKGROUND: Total ankle arthroplasty (TAA) is increasingly common, but risk of amputation after TAA is poorly defined.

METHODS: Patients who underwent TAA between 2010 and 2018 and were verified to be continuously enrolled in a commercial insurance database for 5 subsequent years were evaluated for subsequent lower extremity amputation.

RESULTS: A total of 6439 patients underwent primary TAA; 2134 (33.2%) had diabetes. Over 5 years, 39 major amputations occurred (0.60%). Patients with diabetes had a significantly higher risk of amputation than those without diabetes (0.98% vs 0.42%; RR 2.35 [95% CI 1.26-4.40]; p = 0.0095).

CONCLUSIONS: In this study, the 5-year rate of major amputation following primary TAA was 0.60% overall. The rate was 0.98% in diabetic patients, significantly higher than that in non-diabetic patients. Careful patient selection and optimization of glycemic control remain essential when considering total ankle arthroplasty.