Population-based Projections of Ankle Arthrodeses

Abstract

Category: Ankle Arthritis Introduction/Purpose: Ankle arthrodesis is commonly performed for patients with end stage ankle arthritis. However, with improvements in long-term outcomes following total ankle arthroplasty it is possible that rates of ankle arthrodesis will decrease as utilization of ankle arthroplasty increases. The purpose of this study is to assess the current and future trends of ankle arthrodesis utilization. Methods: National Inpatient Sample (NIS) data from 1997-2014 was used to identify trends in the utilization of ankle arthrodesis. United States Census Bureau data from 1997-2014 was used to identify historical population data and future population estimates. A linear regression model was created using Mathematica v11.3 to project future demand for ankle arthrodesis. The data was stratified to show past and future trends based on gender and age. Results: The overall utilization rate of ankle arthrodesis remained relatively constant from 5897 procedures in 1997 to 5330 procedures in 2014. The overall demand for ankle arthrodesis is expected to increase slightly by 15 percent with 6141 procedures projected in 2045. Stratified by age groups, the number of procedures is predicted to decrease by 75% in ages 18-44 and 6% in ages 45-64, and predicted to increase by 133% in ages 65-84 by 2045. Stratified by gender, ankle arthrodesis is predicted to increase by 47% in males and decrease by 14% in females in 2045. Conclusion: Based on our projection model, the rate of ankle arthrodesis is predicted to stay relatively stable overall but decrease in younger populations. A projected increase in total ankle arthroplasty will likely contribute to decreased utilization of ankle arthrodesis. However, ankle arthrodesis will still be a valuable tool in the surgeon’s armamentarium to treat ankle arthritis.