{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:05:59Z","timestamp":1787169959133,"version":"build-2736575974"},"reference-count":35,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"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 &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is growing focus on surgical costs related to common orthopaedic procedures. In this investigation, we studied surgical costs associated with tibiotalar arthrodesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients were retrospectively identified who had undergone primary fusion of the tibiotalar joint based on\n                      <jats:italic toggle=\"yes\">Current Procedural Terminology<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      ) codes from 2014 to 2020. Using the Value Driven Outcome (VDO) tool, we conducted an evaluation of both total direct costs and facility-related expenses. The VDO tool encompasses a comprehensive item-level database capable of capturing detailed cost information, which is subsequently presented as relative mean data. Adjustments were made to cost variables to reflect 2022 US dollars, and comparative multivariable analysis of costs in relation to treatment groups adjusting for demographic variables was performed using generalized linear models to yield cost ratios along with 95% CIs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Our cohort consisted of 262 patients who underwent primary ankle fusion procedures done by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographic data or total operating room (OR) time based on surgical construct (screws-alone n\u2009=\u2009228 vs anterior plate-screws n\u2009=\u200934). Total direct costs for anterior plate-screw constructs were 78% higher than screws alone (ratio in cost\u2009=\u20091.78, 95% CI 1.55-2.08,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), adjusting for other variables. For all fusion constructs, every 1-hour increase in total OR time increased total direct costs by 29% (ratio in cost\u2009=\u20091.29, 95% CI 1.18-1.40,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Enhancing cost-effectiveness of orthopaedic care remains an important objective. Our investigation found that anterior plate-screw constructs for tibiotalar arthrodesis have notably higher total costs compared with screw-only constructs. Many variables are considered when selecting surgical constructs for ankle arthrodesis. When clinically appropriate, screw-only ankle arthrodesis constructs could be considered if there is a need to reduce costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114251332941","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T07:11:53Z","timestamp":1746515513000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Study of Surgical Costs Associated With Tibiotalar Fusion"],"prefix":"10.1177","volume":"10","author":[{"given":"Kade","family":"Wagers","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Presson","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1328-026X","authenticated-orcid":false,"given":"Devon","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"US Bureau of Economic Analysis. Table 2.5.4. Price indexes for personal consumption expenditures by function. Accessed February 6 2024. https:\/\/apps.bea.gov\/iTable\/?reqid=19&step=3&isuri=1&nipa_table_list=62&categories=survey#eyJhcHBpZCI6MTksInN0ZXBzIjpbMSwyLDNdLCJkYXRhIjpbWyJuaXBhX3RhYmxlX2xpc3QiLCI3MyJdLFsiY2F0ZWdvcmllcyIsIlN1cnZleSJdXX0="},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200005000-00007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2020.03.020"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600707"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-017-9407-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2012.07.001"},{"key":"e_1_3_2_8_2","unstructured":"Dunn PK. Tweedie: Evaluation of Tweedie exponential family models. R package version 2.3. 2022. Accessed February 6 2024. https:\/\/rdrr.io\/cran\/tweedie\/"},{"key":"e_1_3_2_9_2","unstructured":"Dunn PK Smyth G. Series evaluation of Tweedie exponential dispersion models. University of Southern Queensland; 2002."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2009.06.004"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2022.02.016"},{"key":"e_1_3_2_12_2","unstructured":"Hartig F. Residual diagnostics for hierarchical (multi-level\/mixed) regression models. R package version 0.4.6. https:\/\/CRAN.R-project.org\/package=DHARMa"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2007.08.016"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/19386400231171508"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2013-002511"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.04.015"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.03.051"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000203480.04174.0e"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3303-3"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-017-0576-1"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12226"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2007.2404"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716681529"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100803"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.01.007"},{"key":"e_1_3_2_26_2","unstructured":"R Foundation for Statistical Computing. R: A Language and Environment for Statistical Computing. 2023. https:\/\/www.R-project.org\/"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713517101"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v5.i1.1"},{"issue":"7","key":"e_1_3_2_29_2","article-title":"Consumer prices for surgical management of ankle arthritis: limited availability and wide variability","volume":"3","author":"Smyth NA","year":"2019","unstructured":"Smyth NA, Dawkins BJ, Goldstein JP, Kaplan JR, Schon LC, Aiyer AA. Consumer prices for surgical management of ankle arthritis: limited availability and wide variability. J Am Acad Orthop Surg Glob Res Rev. 2019;3(7):e011.","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200710000-00007"},{"issue":"3","key":"e_1_3_2_31_2","first-page":"526","article-title":"Gait analysis and functional outcomes following ankle arthrodesis for isolated ankle arthritis","volume":"88","author":"Thomas R","year":"2006","unstructured":"Thomas R, Daniels TR, Parker K. Gait analysis and functional outcomes following ankle arthrodesis for isolated ankle arthritis. J Bone Joint Surg Am. 2006;88(3):526-535.","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2020.12.011"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2006.11.009"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v7.i11.700"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fastrc.2023.100287"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1074-5"}],"container-title":["Foot &amp; Ankle Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251332941","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24730114251332941","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251332941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:24:12Z","timestamp":1777411452000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24730114251332941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/24730114251332941"],"URL":"https:\/\/doi.org\/10.1177\/24730114251332941","relation":{},"ISSN":["2473-0114","2473-0114"],"issn-type":[{"value":"2473-0114","type":"print"},{"value":"2473-0114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"article-number":"24730114251332941"}}