Prognostic risk factors for complications associated with tibiotalocalcaneal arthrodesis with a nail

Chris Kowalski, Chris Stauch, Ryan Callahan, Kaitlin Saloky, Kempland Walley, Michael Aynardi, Paul Juliano

Research output: Contribution to journalArticle

Abstract

Background: Tibiotalocalcaneal (TTC) arthrodesis with a nail can be an effective salvage procedure for several foot and ankle pathologies, but has a relatively high complication rate. The purpose of this study is to investigate risk factors associated with complications after TTC arthrodesis with a nail. Methods: Clinical and radiographic outcomes for 82 patients from 2012 to 2016 who underwent TTC arthrodesis with a nail were retrospectivelyevaluated to determine if patient or surgeon specific variables offered prognostic value in predicting negative outcomes. Results: Diabetes, diabetic neuropathy, high (>2) American Society of Anesthesiologists (ASA) classification, and Charcot neuroarthropathy all were predictive of developing a nonunion in either the subtalar ortibiotalar joints (p < 0.05). Diabetic neuropathy was predictive ofreoperation, and along with HbA1C >7.5 was also predictive of hardwarefailure. The odds ratio (OR) for diabetic neuropathy was 2.99 (p < 0.05)for nonunion in the tibiotalar or subtalar joints, 3.46 (p < 0.05) for reoperation,and 4.11 (p < 0.05) for hardware failure. High ASAclassification had an odds ratio of 3.93 (p < 0.05) for nonunion in the tibiotalar or subtalar joints as well. Diabetes had an odds ratio of 2.57 (p < 0.05) for nonunion. Conclusions: Patients with diabetic neuropathy, Charcot neuroarthropathy, elevated HbA1C, and ASA classification >2 demonstrated a higher complication rate in patients undergoing TTC arthrodesis with a nail.

Original languageEnglish (US)
JournalFoot and Ankle Surgery
DOIs
StateAccepted/In press - Jan 1 2019

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Arthrodesis
Nails
Diabetic Neuropathies
Subtalar Joint
Ankle
Odds Ratio
Pathology

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

@article{14185d6d48cc4f1aad700f40c54262df,
title = "Prognostic risk factors for complications associated with tibiotalocalcaneal arthrodesis with a nail",
abstract = "Background: Tibiotalocalcaneal (TTC) arthrodesis with a nail can be an effective salvage procedure for several foot and ankle pathologies, but has a relatively high complication rate. The purpose of this study is to investigate risk factors associated with complications after TTC arthrodesis with a nail. Methods: Clinical and radiographic outcomes for 82 patients from 2012 to 2016 who underwent TTC arthrodesis with a nail were retrospectivelyevaluated to determine if patient or surgeon specific variables offered prognostic value in predicting negative outcomes. Results: Diabetes, diabetic neuropathy, high (>2) American Society of Anesthesiologists (ASA) classification, and Charcot neuroarthropathy all were predictive of developing a nonunion in either the subtalar ortibiotalar joints (p < 0.05). Diabetic neuropathy was predictive ofreoperation, and along with HbA1C >7.5 was also predictive of hardwarefailure. The odds ratio (OR) for diabetic neuropathy was 2.99 (p < 0.05)for nonunion in the tibiotalar or subtalar joints, 3.46 (p < 0.05) for reoperation,and 4.11 (p < 0.05) for hardware failure. High ASAclassification had an odds ratio of 3.93 (p < 0.05) for nonunion in the tibiotalar or subtalar joints as well. Diabetes had an odds ratio of 2.57 (p < 0.05) for nonunion. Conclusions: Patients with diabetic neuropathy, Charcot neuroarthropathy, elevated HbA1C, and ASA classification >2 demonstrated a higher complication rate in patients undergoing TTC arthrodesis with a nail.",
author = "Chris Kowalski and Chris Stauch and Ryan Callahan and Kaitlin Saloky and Kempland Walley and Michael Aynardi and Paul Juliano",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.fas.2019.08.015",
language = "English (US)",
journal = "Foot and Ankle Surgery",
issn = "1268-7731",
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Prognostic risk factors for complications associated with tibiotalocalcaneal arthrodesis with a nail. / Kowalski, Chris; Stauch, Chris; Callahan, Ryan; Saloky, Kaitlin; Walley, Kempland; Aynardi, Michael; Juliano, Paul.

In: Foot and Ankle Surgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic risk factors for complications associated with tibiotalocalcaneal arthrodesis with a nail

AU - Kowalski, Chris

AU - Stauch, Chris

AU - Callahan, Ryan

AU - Saloky, Kaitlin

AU - Walley, Kempland

AU - Aynardi, Michael

AU - Juliano, Paul

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Tibiotalocalcaneal (TTC) arthrodesis with a nail can be an effective salvage procedure for several foot and ankle pathologies, but has a relatively high complication rate. The purpose of this study is to investigate risk factors associated with complications after TTC arthrodesis with a nail. Methods: Clinical and radiographic outcomes for 82 patients from 2012 to 2016 who underwent TTC arthrodesis with a nail were retrospectivelyevaluated to determine if patient or surgeon specific variables offered prognostic value in predicting negative outcomes. Results: Diabetes, diabetic neuropathy, high (>2) American Society of Anesthesiologists (ASA) classification, and Charcot neuroarthropathy all were predictive of developing a nonunion in either the subtalar ortibiotalar joints (p < 0.05). Diabetic neuropathy was predictive ofreoperation, and along with HbA1C >7.5 was also predictive of hardwarefailure. The odds ratio (OR) for diabetic neuropathy was 2.99 (p < 0.05)for nonunion in the tibiotalar or subtalar joints, 3.46 (p < 0.05) for reoperation,and 4.11 (p < 0.05) for hardware failure. High ASAclassification had an odds ratio of 3.93 (p < 0.05) for nonunion in the tibiotalar or subtalar joints as well. Diabetes had an odds ratio of 2.57 (p < 0.05) for nonunion. Conclusions: Patients with diabetic neuropathy, Charcot neuroarthropathy, elevated HbA1C, and ASA classification >2 demonstrated a higher complication rate in patients undergoing TTC arthrodesis with a nail.

AB - Background: Tibiotalocalcaneal (TTC) arthrodesis with a nail can be an effective salvage procedure for several foot and ankle pathologies, but has a relatively high complication rate. The purpose of this study is to investigate risk factors associated with complications after TTC arthrodesis with a nail. Methods: Clinical and radiographic outcomes for 82 patients from 2012 to 2016 who underwent TTC arthrodesis with a nail were retrospectivelyevaluated to determine if patient or surgeon specific variables offered prognostic value in predicting negative outcomes. Results: Diabetes, diabetic neuropathy, high (>2) American Society of Anesthesiologists (ASA) classification, and Charcot neuroarthropathy all were predictive of developing a nonunion in either the subtalar ortibiotalar joints (p < 0.05). Diabetic neuropathy was predictive ofreoperation, and along with HbA1C >7.5 was also predictive of hardwarefailure. The odds ratio (OR) for diabetic neuropathy was 2.99 (p < 0.05)for nonunion in the tibiotalar or subtalar joints, 3.46 (p < 0.05) for reoperation,and 4.11 (p < 0.05) for hardware failure. High ASAclassification had an odds ratio of 3.93 (p < 0.05) for nonunion in the tibiotalar or subtalar joints as well. Diabetes had an odds ratio of 2.57 (p < 0.05) for nonunion. Conclusions: Patients with diabetic neuropathy, Charcot neuroarthropathy, elevated HbA1C, and ASA classification >2 demonstrated a higher complication rate in patients undergoing TTC arthrodesis with a nail.

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U2 - 10.1016/j.fas.2019.08.015

DO - 10.1016/j.fas.2019.08.015

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JO - Foot and Ankle Surgery

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