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Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019
Introduction Contemporary studies evaluating utilization and trends of total ankle arthroplasty (TAA) and ankle fusion (AF) for tibiotalar osteoarthritis are sparse. Therefore, the purpose of this study was to utilize a nationwide administrative claims database from 2010 to 2019 to compare: (1) base...
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| Published in: | Archives of orthopaedic and trauma surgery 2023-06, Vol.143 (6), p.2913-2918 |
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| creator | Gordon, Adam M. Lam, Aaron W. Golub, Ivan J. Pasternack, Jordan B. Abdelgawad, Amr A. |
| description | Introduction
Contemporary studies evaluating utilization and trends of total ankle arthroplasty (TAA) and ankle fusion (AF) for tibiotalar osteoarthritis are sparse. Therefore, the purpose of this study was to utilize a nationwide administrative claims database from 2010 to 2019 to compare: (1) baseline demographics; (2) utilization, (3) in-hospital length of stay (LOS), and (4) costs of care.
Methods
Using the PearlDiver database, a retrospective query from January 1st, 2010 to December 31st, 2019 was performed for all patients who underwent TAA and AF for tibiotalar osteoarthritis. Baseline demographics, comorbidities, and geographic utilization were compared using Pearson Chi-square analyses. Linear regression was used to compare differences in procedure utilization and in-hospital LOS during the study interval. Reimbursements between the two cohorts during the study interval were compared. A
p
value less than 0.05 was statistically significant.
Results
In total, 14,248 patients underwent primary TAA (
n
= 5544) or AF (
n
= 8704). Patients undergoing AF were generally younger ( |
| doi_str_mv | 10.1007/s00402-022-04481-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2672704928</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2672704928</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-2998b31b33075a8a35fbcef382d5559b4b4bff4c3158241229c31fa4b412a7c13</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi0EotcXYFFZYsOiAV-P7SU64lKpEgvo2nISu8cliVPbWZT36Pt2TlMKYoEsa0Yz3__b0o_QG0reU0LUh0KIIKwhDK4QmjbqBTqkgouGG7p5-Vd_gI5KuSGEMm3Ia3TA5UYyI8khut-mcXY5ljThFPDsavRTxb0f03V28y525RwvNQ7xF6wAqtlPPczc1OMulVr2spqqG2D0c_DY5brLaR5cqXeP1DoOS9nLIzjsPL6aYvU9_l5d9QWHnEbMCCVgtK_mBL0Kbij-9Kkeo6vPn35svzaX375cbD9eNh1XsjbMGN1y2nJOlHTacRnazgeuWS-lNK2AE4LoOJWaCcqYgTY4GFPmVEf5MXq3-s453S6-VDvG0vlhcJNPS7Fso5giwjAN6Nt_0Ju05Al-Z5mmYkO14gYotlJdTqVkH-yc4-jynaXE7kOza2gWQrOPoVkForMn66Udff8s-Z0SAHwFCqyma5__vP0f2weSI6Gv</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2814618739</pqid></control><display><type>article</type><title>Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019</title><source>Springer Link</source><creator>Gordon, Adam M. ; Lam, Aaron W. ; Golub, Ivan J. ; Pasternack, Jordan B. ; Abdelgawad, Amr A.</creator><creatorcontrib>Gordon, Adam M. ; Lam, Aaron W. ; Golub, Ivan J. ; Pasternack, Jordan B. ; Abdelgawad, Amr A.</creatorcontrib><description>Introduction
Contemporary studies evaluating utilization and trends of total ankle arthroplasty (TAA) and ankle fusion (AF) for tibiotalar osteoarthritis are sparse. Therefore, the purpose of this study was to utilize a nationwide administrative claims database from 2010 to 2019 to compare: (1) baseline demographics; (2) utilization, (3) in-hospital length of stay (LOS), and (4) costs of care.
Methods
Using the PearlDiver database, a retrospective query from January 1st, 2010 to December 31st, 2019 was performed for all patients who underwent TAA and AF for tibiotalar osteoarthritis. Baseline demographics, comorbidities, and geographic utilization were compared using Pearson Chi-square analyses. Linear regression was used to compare differences in procedure utilization and in-hospital LOS during the study interval. Reimbursements between the two cohorts during the study interval were compared. A
p
value less than 0.05 was statistically significant.
Results
In total, 14,248 patients underwent primary TAA (
n
= 5544) or AF (
n
= 8704). Patients undergoing AF were generally younger (< 60) with greater comorbidity burden driven by hypertension, diabetes mellitus, obesity, and tobacco use compared to TAA patients (
p
< 0.0001). Over the study interval, TAA utilization remained constant (912 vs 909 procedures;
p
= 0.807), whereas AF utilization decreased by 42.5% (1737 vs 998 procedures;
p
= 0.0001). Mean in-hospital LOS for patients undergoing TAA decreased (2.5 days vs. 2.0 days,
p
= 0.0004), while AF LOS increased (2.6 days vs. 3.5 days,
p
= 0.0003). Reimbursements for both procedures significantly declined over the study interval (TAA: $4559–$2156, AF: $4729–$1721;
p
< 0.013).
Conclusion
TAA utilization remained constant, while AF utilization declined by 42.5% from 2010 to 2019. There was divergence in the LOS for TAA versus AF patients. Both procedures significantly declined by over 50% in reimbursements over the study interval.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-022-04481-7</identifier><identifier>PMID: 35652950</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Ankle ; Ankle - surgery ; Ankle Joint - surgery ; Arthritis ; Arthroplasty, Replacement, Ankle - methods ; Demographics ; Demography ; Humans ; Joint surgery ; Medicine ; Medicine & Public Health ; Orthopaedic Surgery ; Orthopedics ; Osteoarthritis ; Osteoarthritis - surgery ; Retrospective Studies ; Trends ; United States</subject><ispartof>Archives of orthopaedic and trauma surgery, 2023-06, Vol.143 (6), p.2913-2918</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-2998b31b33075a8a35fbcef382d5559b4b4bff4c3158241229c31fa4b412a7c13</citedby><cites>FETCH-LOGICAL-c375t-2998b31b33075a8a35fbcef382d5559b4b4bff4c3158241229c31fa4b412a7c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35652950$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gordon, Adam M.</creatorcontrib><creatorcontrib>Lam, Aaron W.</creatorcontrib><creatorcontrib>Golub, Ivan J.</creatorcontrib><creatorcontrib>Pasternack, Jordan B.</creatorcontrib><creatorcontrib>Abdelgawad, Amr A.</creatorcontrib><title>Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Contemporary studies evaluating utilization and trends of total ankle arthroplasty (TAA) and ankle fusion (AF) for tibiotalar osteoarthritis are sparse. Therefore, the purpose of this study was to utilize a nationwide administrative claims database from 2010 to 2019 to compare: (1) baseline demographics; (2) utilization, (3) in-hospital length of stay (LOS), and (4) costs of care.
Methods
Using the PearlDiver database, a retrospective query from January 1st, 2010 to December 31st, 2019 was performed for all patients who underwent TAA and AF for tibiotalar osteoarthritis. Baseline demographics, comorbidities, and geographic utilization were compared using Pearson Chi-square analyses. Linear regression was used to compare differences in procedure utilization and in-hospital LOS during the study interval. Reimbursements between the two cohorts during the study interval were compared. A
p
value less than 0.05 was statistically significant.
Results
In total, 14,248 patients underwent primary TAA (
n
= 5544) or AF (
n
= 8704). Patients undergoing AF were generally younger (< 60) with greater comorbidity burden driven by hypertension, diabetes mellitus, obesity, and tobacco use compared to TAA patients (
p
< 0.0001). Over the study interval, TAA utilization remained constant (912 vs 909 procedures;
p
= 0.807), whereas AF utilization decreased by 42.5% (1737 vs 998 procedures;
p
= 0.0001). Mean in-hospital LOS for patients undergoing TAA decreased (2.5 days vs. 2.0 days,
p
= 0.0004), while AF LOS increased (2.6 days vs. 3.5 days,
p
= 0.0003). Reimbursements for both procedures significantly declined over the study interval (TAA: $4559–$2156, AF: $4729–$1721;
p
< 0.013).
Conclusion
TAA utilization remained constant, while AF utilization declined by 42.5% from 2010 to 2019. There was divergence in the LOS for TAA versus AF patients. Both procedures significantly declined by over 50% in reimbursements over the study interval.</description><subject>Ankle</subject><subject>Ankle - surgery</subject><subject>Ankle Joint - surgery</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Ankle - methods</subject><subject>Demographics</subject><subject>Demography</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis - surgery</subject><subject>Retrospective Studies</subject><subject>Trends</subject><subject>United States</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1TAQhi0EotcXYFFZYsOiAV-P7SU64lKpEgvo2nISu8cliVPbWZT36Pt2TlMKYoEsa0Yz3__b0o_QG0reU0LUh0KIIKwhDK4QmjbqBTqkgouGG7p5-Vd_gI5KuSGEMm3Ia3TA5UYyI8khut-mcXY5ljThFPDsavRTxb0f03V28y525RwvNQ7xF6wAqtlPPczc1OMulVr2spqqG2D0c_DY5brLaR5cqXeP1DoOS9nLIzjsPL6aYvU9_l5d9QWHnEbMCCVgtK_mBL0Kbij-9Kkeo6vPn35svzaX375cbD9eNh1XsjbMGN1y2nJOlHTacRnazgeuWS-lNK2AE4LoOJWaCcqYgTY4GFPmVEf5MXq3-s453S6-VDvG0vlhcJNPS7Fso5giwjAN6Nt_0Ju05Al-Z5mmYkO14gYotlJdTqVkH-yc4-jynaXE7kOza2gWQrOPoVkForMn66Udff8s-Z0SAHwFCqyma5__vP0f2weSI6Gv</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Gordon, Adam M.</creator><creator>Lam, Aaron W.</creator><creator>Golub, Ivan J.</creator><creator>Pasternack, Jordan B.</creator><creator>Abdelgawad, Amr A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20230601</creationdate><title>Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019</title><author>Gordon, Adam M. ; Lam, Aaron W. ; Golub, Ivan J. ; Pasternack, Jordan B. ; Abdelgawad, Amr A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-2998b31b33075a8a35fbcef382d5559b4b4bff4c3158241229c31fa4b412a7c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ankle</topic><topic>Ankle - surgery</topic><topic>Ankle Joint - surgery</topic><topic>Arthritis</topic><topic>Arthroplasty, Replacement, Ankle - methods</topic><topic>Demographics</topic><topic>Demography</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis - surgery</topic><topic>Retrospective Studies</topic><topic>Trends</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gordon, Adam M.</creatorcontrib><creatorcontrib>Lam, Aaron W.</creatorcontrib><creatorcontrib>Golub, Ivan J.</creatorcontrib><creatorcontrib>Pasternack, Jordan B.</creatorcontrib><creatorcontrib>Abdelgawad, Amr A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gordon, Adam M.</au><au>Lam, Aaron W.</au><au>Golub, Ivan J.</au><au>Pasternack, Jordan B.</au><au>Abdelgawad, Amr A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>143</volume><issue>6</issue><spage>2913</spage><epage>2918</epage><pages>2913-2918</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Contemporary studies evaluating utilization and trends of total ankle arthroplasty (TAA) and ankle fusion (AF) for tibiotalar osteoarthritis are sparse. Therefore, the purpose of this study was to utilize a nationwide administrative claims database from 2010 to 2019 to compare: (1) baseline demographics; (2) utilization, (3) in-hospital length of stay (LOS), and (4) costs of care.
Methods
Using the PearlDiver database, a retrospective query from January 1st, 2010 to December 31st, 2019 was performed for all patients who underwent TAA and AF for tibiotalar osteoarthritis. Baseline demographics, comorbidities, and geographic utilization were compared using Pearson Chi-square analyses. Linear regression was used to compare differences in procedure utilization and in-hospital LOS during the study interval. Reimbursements between the two cohorts during the study interval were compared. A
p
value less than 0.05 was statistically significant.
Results
In total, 14,248 patients underwent primary TAA (
n
= 5544) or AF (
n
= 8704). Patients undergoing AF were generally younger (< 60) with greater comorbidity burden driven by hypertension, diabetes mellitus, obesity, and tobacco use compared to TAA patients (
p
< 0.0001). Over the study interval, TAA utilization remained constant (912 vs 909 procedures;
p
= 0.807), whereas AF utilization decreased by 42.5% (1737 vs 998 procedures;
p
= 0.0001). Mean in-hospital LOS for patients undergoing TAA decreased (2.5 days vs. 2.0 days,
p
= 0.0004), while AF LOS increased (2.6 days vs. 3.5 days,
p
= 0.0003). Reimbursements for both procedures significantly declined over the study interval (TAA: $4559–$2156, AF: $4729–$1721;
p
< 0.013).
Conclusion
TAA utilization remained constant, while AF utilization declined by 42.5% from 2010 to 2019. There was divergence in the LOS for TAA versus AF patients. Both procedures significantly declined by over 50% in reimbursements over the study interval.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35652950</pmid><doi>10.1007/s00402-022-04481-7</doi><tpages>6</tpages></addata></record> |
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| subjects | Ankle Ankle - surgery Ankle Joint - surgery Arthritis Arthroplasty, Replacement, Ankle - methods Demographics Demography Humans Joint surgery Medicine Medicine & Public Health Orthopaedic Surgery Orthopedics Osteoarthritis Osteoarthritis - surgery Retrospective Studies Trends United States |
| title | Comparison of patient demographics, utilization trends, and costs of total ankle arthroplasty and ankle fusion in the United States from 2010 to 2019 |
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