{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:12:07Z","timestamp":1788862327197,"version":"build-2803163510"},"reference-count":25,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ankle arthrodesis (AA) has historically been the gold standard surgical treatment for end-stage ankle arthritis, providing reliable pain relief at the expense of motion. Total ankle arthroplasty (TAA) has emerged as a motion-preserving alternative with improving survivorship and functional outcomes. However, large-scale comparative data evaluating complications, reoperation rates, opioid utilization, and health care costs remain limited. This study compared outcomes following AA and TAA using a national administrative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was performed using a national claims database. Adult patients undergoing primary TAA or AA were identified, excluding cases involving trauma, infection, or malignancy. Propensity score matching (1:1) was performed based on age, sex, year of surgery, insurance type, and comorbidities. Thirty-day complications, 2-year outcomes, postoperative opioid utilization, and cumulative health care costs were assessed. Categorical variables were compared using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      testing and continuous variables using independent-samples t-tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 15\u2009898 patients met inclusion criteria (9271 AA; 6627 TAA). After matching, 6627 patients remained in each cohort. At 2 years, TAA demonstrated lower rates of any reoperation compared with AA (3.1% vs 7.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), driven by lower rates of revision (1.1% vs 3.3%), hardware removal (1.3% vs 5.5%), and infection-related reoperations (1.3% vs 1.9%) (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Diagnosis-based endpoints, reported separately, similarly favored TAA. Within 30 days, TAA was associated with fewer complications (1.0% vs 2.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Although index costs were modestly higher for TAA, cumulative costs at 2 years were lower ($7225 vs $8043,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Early opioid use was slightly higher following TAA but converged by 1 year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In a propensity-matched national cohort, TAA demonstrated lower reoperation rates, fewer early complications, and lower cumulative costs at 2 years compared with AA, supporting TAA as a durable treatment option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007261444267","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T08:52:58Z","timestamp":1779180778000},"page":"944-951","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complications, Reoperations, and Healthcare Costs Following Total Ankle Arthroplasty vs Ankle Arthrodesis"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0427-9999","authenticated-orcid":false,"given":"Jacob W.","family":"McDevitt","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4030-3858","authenticated-orcid":false,"given":"Eric H.","family":"Durudogan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4943-328X","authenticated-orcid":false,"given":"Milap S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8622-6793","authenticated-orcid":false,"given":"Muhammad Y.","family":"Mutawakkil","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-6407","authenticated-orcid":false,"given":"Anish R.","family":"Kadakia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0543-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10194489"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-25-00590"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2016.10.019"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1074-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720946740"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.00060"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B11.31633"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.01257"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01341"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-50091-6"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B5.36887"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2020.01.015"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2025.11.021"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714558511"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007251401557"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3310\/PTYJ1146"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3791\/56396"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01423"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2023.04.006"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14092909"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-23-00743"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2024.05.002"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1709312"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2019.10.011"}],"container-title":["Foot &amp; 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