{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:10:00Z","timestamp":1792131000394,"version":"4.4.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Treatment of ankle osteoarthritis by total ankle replacement (TAR) is increasing worldwide. The aim of the study was to present the overall temporal trends of TAR throughout 22\u00a0years (2001\u20132022) in Italy, analyzing the distributions of hospitals by volume of activity and patients by age and sex, drawing on the National Hospital Discharge Record database. Furthermore, as a secondary aim, we compared these trends with those of ankle fusions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>International Classification of Diseases, 9th Revision, Clinical Modification (ICD9-CM) codes of interest were identified to browse the Italian National Hospital Discharge Record database. Surgical volumes, trends over time, classes of hospital activity volume, sex and age of patients, and population incidence rates were described. The statistical significance of time series trends was assessed by the Cox\u2013Stuart test with randomness as a null hypothesis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>20,248 ankle procedures (total ankle replacements 8853 and ankle fusions 11,395) were extracted from 231,601,523 admissions registered nationally from 2001 to 2022. The yearly total number of TARs significantly increased almost tenfold from 96 to 996 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), while the number of fusions exhibited a stationary behavior (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The increased trend in TAR procedures was concentrated mostly in the North of Italy, with predominantly males between 55 and 64\u00a0years of age. The analysis of the number of procedures performed on inhabitants by region and that performed by all the hospitals in the region showed a different pattern across Italy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The substantial increase in TARs may be owing to improved implant designs and innovative surgical technologies, which allow the treatment of more severe cases and deformities, previously untreated or treated by a fusion. This trend highlights the need to invest in implementing high quality registries by promoting surgeons\u2019 participation in data collection.<\/jats:p>\n            <jats:p>\n              <jats:italic>Level of evidence<\/jats:italic>: population based study, level 1 evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s10195-024-00809-8","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T19:12:04Z","timestamp":1738177924000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is the treatment of ankle osteoarthritis changing over time in Italy? Analysis of temporal trends for fusion and arthroplasty in a population-based study from 2001 to 2022 on the National Hospital Discharge Record database"],"prefix":"10.1186","volume":"26","author":[{"given":"Adriano","family":"Cuccu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Manuela","family":"Samaila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6621-5480","authenticated-orcid":false,"given":"Enrico","family":"Ciminello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Alfieri Montrasio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Cortese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Ceccarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Falcone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Torre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"11","key":"809_CR1","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.2106\/JBJS.F.00295","volume":"88","author":"CL Saltzman","year":"2006","unstructured":"Saltzman CL, Zimmerman MB, O\u2019Rourke M, Brown TD, Buckwalter JA, Johnston R (2006) Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. J Bone Joint Surg Am 88(11):2366\u20132372. https:\/\/doi.org\/10.2106\/JBJS.F.00295","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"809_CR2","doi-asserted-by":"publisher","first-page":"579","DOI":"10.3113\/FAI.2009.0579","volume":"30","author":"CL Saltzman","year":"2009","unstructured":"Saltzman CL, Mann RA, Ahrens JE, Amendola A, Anderson RB, Berlet GC, Brodsky JW, Chou LB, Clanton TO, Deland JT, Deorio JK, Horton GA, Lee TH, Mann JA, Nunley JA, Thordarson DB, Walling AK, Wapner KL, Coughlin MJ (2009) Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int 30(7):579\u2013596. https:\/\/doi.org\/10.3113\/FAI.2009.0579","journal-title":"Foot Ankle Int"},{"key":"809_CR3","first-page":"44","volume":"25","author":"CL Saltzman","year":"2005","unstructured":"Saltzman CL, Salamon ML, Blanchard GM, Huff T, Hayes A, Buckwalter JA, Amendola A (2005) Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J 25:44\u201346","journal-title":"Iowa Orthop J"},{"issue":"2","key":"809_CR4","doi-asserted-by":"publisher","first-page":"219","DOI":"10.2106\/00004623-200102000-00009","volume":"83","author":"LM Coester","year":"2001","unstructured":"Coester LM, Saltzman CL, Leupold J, Pontarelli W (2001) Long- term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am 83(2):219\u2013228. https:\/\/doi.org\/10.2106\/00004623-200102000-00009","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"809_CR5","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1007\/s11999-011-1848-4","volume":"469","author":"XF Courville","year":"2011","unstructured":"Courville XF, Hecht PJ, Tosteson AN (2011) Is total ankle arthroplasty a cost-effective alternative to ankle fusion? Clin Orthop Relat Res 469(6):1721\u20131727. https:\/\/doi.org\/10.1007\/s11999-011-1848-4","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"809_CR6","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.2106\/JBJS.F.01611","volume":"89","author":"NF SooHoo","year":"2007","unstructured":"SooHoo NF, Zingmond DS, Ko CY (2007) Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am 89(10):2143\u20132149. https:\/\/doi.org\/10.2106\/JBJS.F.01611","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"809_CR7","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.2106\/00004623-200406000-00008","volume":"86-A","author":"AA Spirt","year":"2004","unstructured":"Spirt AA, Assal M, Hansen ST Jr (2004) Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am 86-A(6):1172\u20131178. https:\/\/doi.org\/10.2106\/00004623-200406000-00008","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"809_CR8","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s13018-017-0576-1","volume":"12","author":"CD Lawton","year":"2017","unstructured":"Lawton CD, Butler BA, Dekker RG 2nd, Prescott A, Kadakia AR (2017) Total ankle arthroplasty versus ankle arthrodesis\u2014a comparison of outcomes over the last decade. J Orthop Surg Res 12(1):76. https:\/\/doi.org\/10.1186\/s13018-017-0576-1","journal-title":"J Orthop Surg Res"},{"issue":"2","key":"809_CR9","doi-asserted-by":"publisher","first-page":"256","DOI":"10.3113\/FAI.2008.0256","volume":"29","author":"AJ Guyer","year":"2008","unstructured":"Guyer AJ, Richardson G (2008) Current concepts review: total ankle arthroplasty. Foot Ankle Int 29(2):256\u2013264. https:\/\/doi.org\/10.3113\/FAI.2008.0256","journal-title":"Foot Ankle Int"},{"key":"809_CR10","first-page":"383","volume":"57","author":"JK DeOrio","year":"2008","unstructured":"DeOrio JK, Easley ME (2008) Total ankle arthroplasty. Instr Course Lect 57:383\u2013413","journal-title":"Instr Course Lect"},{"issue":"1","key":"809_CR11","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s11999-009-0987-3","volume":"468","author":"NE Gougoulias","year":"2010","unstructured":"Gougoulias NE, Khanna A, Maffulli N (2010) How successful are current ankle replacements? A systematic review of the literature. Clin Orthop Relat Res 468(1):199\u2013208. https:\/\/doi.org\/10.1007\/s11999-009-0987-3","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"809_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cpm.2012.08.005","volume":"30","author":"NE Gougoulias","year":"2013","unstructured":"Gougoulias NE, Maffulli N (2013) History of total ankle replacement. Clin Podiatr Med Surg 30(1):1\u201320. https:\/\/doi.org\/10.1016\/j.cpm.2012.08.005","journal-title":"Clin Podiatr Med Surg"},{"issue":"2","key":"809_CR13","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.fas.2009.09.001","volume":"16","author":"TWD Smith","year":"2010","unstructured":"Smith TWD, Stephens M (2010) Ankle arthroplasty. Foot Ankle Surg 16(2):53. https:\/\/doi.org\/10.1016\/j.fas.2009.09.001","journal-title":"Foot Ankle Surg"},{"issue":"2","key":"809_CR14","first-page":"150","volume":"76","author":"A van den Heuvel","year":"2010","unstructured":"van den Heuvel A, Van Bouwel S, Dereymaeker G (2010) Total ankle replacement. Design evolution and results. Acta Orthop Belg 76(2):150\u2013161","journal-title":"Acta Orthop Belg"},{"issue":"15","key":"809_CR15","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.2106\/JBJS.J.00126","volume":"93","author":"ME Easley","year":"2011","unstructured":"Easley ME, Adams SB Jr, Hembree WC, DeOrio JK (2011) Results of total ankle arthroplasty. J Bone Joint Surg Am 93(15):1455\u20131468. https:\/\/doi.org\/10.2106\/JBJS.J.00126","journal-title":"J Bone Joint Surg Am"},{"issue":"9","key":"809_CR16","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.2106\/JBJS.F.01149","volume":"89","author":"SL Haddad","year":"2007","unstructured":"Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L (2007) Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am 89(9):1899\u20131905. https:\/\/doi.org\/10.2106\/JBJS.F.01149","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"809_CR17","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1053\/j.jfas.2013.08.006","volume":"52","author":"TS Roukis","year":"2013","unstructured":"Roukis TS, Prissel MA (2013) Registry data trends of total ankle replacement use. J Foot Ankle Surg 52(6):728\u2013735. https:\/\/doi.org\/10.1053\/j.jfas.2013.08.006","journal-title":"J Foot Ankle Surg"},{"issue":"2","key":"809_CR18","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1177\/1071100715606477","volume":"37","author":"CE Gross","year":"2016","unstructured":"Gross CE, Lampley A, Green CL, DeOrio JK, Easley M, Adams S, Nunley JA 2nd (2016) The effect of obesity on functional outcomes and complications in total ankle arthroplasty. Foot Ankle Int 37(2):137\u2013141. https:\/\/doi.org\/10.1177\/1071100715606477","journal-title":"Foot Ankle Int"},{"issue":"8","key":"809_CR19","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1177\/1071100715579717","volume":"36","author":"CA Demetracopoulos","year":"2015","unstructured":"Demetracopoulos CA, Adams SB Jr, Queen RM, DeOrio JK, Nunley JA 2nd, Easley ME (2015) Effect of age on outcomes in total ankle arthroplasty. Foot Ankle Int 36(8):871\u2013880. https:\/\/doi.org\/10.1177\/1071100715579717","journal-title":"Foot Ankle Int"},{"key":"809_CR20","unstructured":"Hospital Discharge Records (HDRs). General Direction of health planning\u2014Office 6 Ministry of health. Annual report on hospitalization activity. HDR Data 2019. Rome: 2020. Available at: https:\/\/www.salute.gov.it\/portale\/documentazione\/p6_2_2_1.jsp?lingua=italiano&id=3002 (last access May, 2nd 2024) [Original in Italian: SDO. Direzione Generale della Programmazione sanitaria - Ufficio 6 Ministero della Salute. Rapporto annuale sull\u2019attivit\u00e0 di ricovero ospedaliero. Dati SDO 2019. Roma: 2020. Available at: https:\/\/www.salute.gov.it\/portale\/documentazione\/p6_2_2_1.jsp?lingua=italiano&id=3002 (last access May, 2nd 2024).]"},{"key":"809_CR21","unstructured":"Ciminello E, Madi SA, Laricchiuta P, Torre M (2023) Joint replacements in Italy. Hospital Discharge Data analysis 2020\u20132021 (Appendix 2A). In: Torre M, Ceccarelli S, Biondi A, Ciccarelli P, Masciocchi M (eds) Italian Arthroplasty Registry. Annual Report 2022, Il Pensiero Scientifico Editore, Roma, pp. 65\u2013108 [Original in Italian: Ciminello E, Madi SA, Laricchiuta P, Torre M (2023) Interventi di artroprotesi: analisi dei dati SDO nazionali 2020 e 2021 (Appendix 2A). In: Torre M, Ceccarelli S, Biondi A, Ciccarelli P, Masciocchi M (eds) Registro Italiano ArtroProtesi. Report Annuale 2022, Il Pensiero Scientifico Editore, Roma, pp 65\u2013108]"},{"key":"809_CR22","unstructured":"ISTAT (2024). http:\/\/dati.istat.it\/. Accessed 17 Jul 2024."},{"issue":"6","key":"809_CR23","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1053\/j.jfas.2018.03.037","volume":"57","author":"D Rybalko","year":"2018","unstructured":"Rybalko D, Schwarzman G, Moretti V (2018) Recent national trends and outcomes in total ankle arthroplasty in the United States. J Foot Ankle Surg 57(6):1092\u20131095. https:\/\/doi.org\/10.1053\/j.jfas.2018.03.037","journal-title":"J Foot Ankle Surg"},{"issue":"7","key":"809_CR24","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1302\/0301-620X.103B7.BJJ-2020-2058.R2","volume":"103-B","author":"DN Townshend","year":"2021","unstructured":"Townshend DN, Bing AJF, Clough TM, Sharpe IT, Goldberg A, UK INFINITY study group (2021) Early experience and patient-reported outcomes of 503 INFINITY total ankle arthroplasties. Bone Jt 103-B(7):1270\u20131276. https:\/\/doi.org\/10.1302\/0301-620X.103B7.BJJ-2020-2058.R2","journal-title":"Bone Jt"},{"issue":"4","key":"809_CR25","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1007\/s00590-024-03884-z","volume":"34","author":"M Yasutomi","year":"2024","unstructured":"Yasutomi M, An VVG, Xu J, Wines A, Sivakumar BS, Symes MJ (2024) Trends in the use of ankle arthrodesis and total ankle replacements in Australia over the past 20 years. Eur J Orthop Surg Traumatol 34(4):1997\u20132001. https:\/\/doi.org\/10.1007\/s00590-024-03884-z","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"809_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.recot.2020.10.011","author":"CD Novoa-Parra","year":"2021","unstructured":"Novoa-Parra CD, Gil-Monz\u00f3 E, D\u00edaz-Fern\u00e1ndez R, Lizaur-Utrilla A (2021) Trend in Spain in the use of total ankle arthroplasty versus arthrodesis in the period 1997\u20132017. Rev Esp Cir Ortop Traumatol. https:\/\/doi.org\/10.1016\/j.recot.2020.10.011","journal-title":"Rev Esp Cir Ortop Traumatol"},{"issue":"3","key":"809_CR27","doi-asserted-by":"publisher","first-page":"247301142211171","DOI":"10.1177\/24730114221117150","volume":"7","author":"PG Brodeur","year":"2022","unstructured":"Brodeur PG, Walsh DF, Modest JM, Salameh M, Licht AH, Hartnett DA, Gil J, Cruz AI Jr, Hsu RY (2022) Trends and reported complications in ankle arthroplasty and ankle arthrodesis in the state of New York, 2009\u20132018. Foot Ankle Orthop 7(3):24730114221117150. https:\/\/doi.org\/10.1177\/24730114221117150","journal-title":"Foot Ankle Orthop"},{"key":"809_CR28","unstructured":"Torre M, Urakcheeva I, Ciminello E, Aprato A, Favella L, Ferro S, Ercolanoni M, Leoni O, Picus R, Armaroli C, Molinari M, Bachini L, Gemmi F, Germinario C, Moretti B, Allotta A, Boniforti F, Ceccarelli S, Laricchiuta P (2021) Impact of COVID-19 pandemic emergency on joint arthroplasties in seven Italian Regions. Version of March 17, 2021. Roma: Istituto Superiore di Sanit\u00e0 (Rapporto ISS COVID-19 n. 7\/2021 Rev. (in Italian)). Available at https:\/\/www.iss.it\/rapporti-covid-19. Accessed 17 Jul 2024."},{"issue":"8","key":"809_CR29","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1007\/s00167-021-06529-4","volume":"29","author":"C Knebel","year":"2021","unstructured":"Knebel C, Ertl M, Lenze U, Suren C, Dinkel A, Hirschmann MT, von Eisenhart-Rothe R, Pohlig F (2021) COVID-19-related cancellation of elective orthopaedic surgery caused increased pain and psychosocial distress levels. Knee Surg Sports Traumatol Arthrosc 29(8):2379\u20132385. https:\/\/doi.org\/10.1007\/s00167-021-06529-4","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"809_CR30","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1007\/s00167-020-06032-2","volume":"28","author":"MC Liebensteiner","year":"2020","unstructured":"Liebensteiner MC, Khosravi I, Hirschmann MT, Heuberer PR, Board of the AGA-Society of Arthroscopy and Joint-Surgery, Thaler M (2020) Massive cutback in orthopaedic healthcare services due to the COVID-19 pandemic. Knee Surg Sports Traumatol Arthrosc 28(6):1705\u20131711. https:\/\/doi.org\/10.1007\/s00167-020-06032-2","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"809_CR31","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1741-7015-7-12","volume":"7","author":"RF van Vollenhoven","year":"2009","unstructured":"van Vollenhoven RF (2009) Sex differences in rheumatoid arthritis: more than meets the eye. BMC Med 7:12. https:\/\/doi.org\/10.1186\/1741-7015-7-12","journal-title":"BMC Med"},{"issue":"6","key":"809_CR32","doi-asserted-by":"publisher","first-page":"491","DOI":"10.4085\/1062-6050-51.5.08","volume":"52","author":"AC Thomas","year":"2016","unstructured":"Thomas AC, Hubbard-Turner T, Wikstrom EA, Palmieri-Smith RM (2016) Epidemiology of posttraumatic osteoarthritis. J Athl Train 52(6):491\u2013496. https:\/\/doi.org\/10.4085\/1062-6050-51.5.08","journal-title":"J Athl Train"},{"key":"809_CR33","doi-asserted-by":"publisher","unstructured":"Zhou B and Tang K. (2016) The current trend of total ankle replacement. In: Arthroplasty\u2014a comprehensive review. IntechOpen. pp 3\u201323. https:\/\/doi.org\/10.5772\/62192","DOI":"10.5772\/62192"},{"issue":"7","key":"809_CR34","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.1007\/s11999-008-0543-6","volume":"467","author":"V Valderrabano","year":"2009","unstructured":"Valderrabano V, Horisberger M, Russell I, Dougall H, Hintermann B (2009) Etiology of ankle osteoarthritis. Clin Orthop Relat Res 467(7):1800\u20131806. https:\/\/doi.org\/10.1007\/s11999-008-0543-6","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"809_CR35","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s10195-023-00740-4","volume":"24","author":"S Pagano","year":"2023","unstructured":"Pagano S, Holzapfel S, Kappenschneider T, Meyer M, Maderbacher G, Grifka J, Holzapfel DE (2023) Arthrosis diagnosis and treatment recommendations in clinical practice: an exploratory investigation with the generative AI model GPT-4. J Orthop Traumatol 24(1):61. https:\/\/doi.org\/10.1186\/s10195-023-00740-4","journal-title":"J Orthop Traumatol"},{"issue":"1","key":"809_CR36","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s10195-023-00716-4","volume":"24","author":"E Artioli","year":"2023","unstructured":"Artioli E, Mazzotti A, Gerardi S, Arceri A, Barile F, Manzetti M, Viroli G, Ruffilli A, Faldini C (2023) Retrograde drilling for ankle joint osteochondral lesions: a systematic review. J Orthop Traumatol 24(1):37. https:\/\/doi.org\/10.1186\/s10195-023-00716-4","journal-title":"J Orthop Traumatol"},{"key":"809_CR37","unstructured":"Romanini E, Torre M, Manno V, Baglio G, Conti S (2008) Interregional mobility and hip replacement. GIOT 34:129\u2013134 [Original in Italian: Romanini E, Torre M, Manno V, Baglio G, Conti S (2008) Chirurgia protesica dell\u2019anca: la mobilit\u00e0 interregionale. GIOT 34:129\u2013134]"},{"key":"809_CR38","unstructured":"Romanini E, Manno V, Conti S, Baglio G, Di Gennaro S, Masciocchi M, Torre M (2009) Interregional mobility for total knee arthroplasty. Ann Ig 21(4):329\u2013336 [Original in Italian: Romanini E, Manno V, Conti S, Baglio G, Di Gennaro S, Masciocchi M, Torre M (2009) Mobilit\u00e0 interregionale e chirurgia protesica del ginocchio. Ann Ig 21(4):329\u2013336]"},{"issue":"1","key":"809_CR39","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1186\/s13018-019-1531-0","volume":"14","author":"SH Mufarrih","year":"2019","unstructured":"Mufarrih SH, Ghani MOA, Martins RS, Qureshi NQ, Mufarrih SA, Malik AT, Noordin S (2019) Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res 14(1):468. https:\/\/doi.org\/10.1186\/s13018-019-1531-0","journal-title":"J Orthop Surg Res"},{"issue":"9","key":"809_CR40","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.3390\/healthcare9091182","volume":"9","author":"N Nante","year":"2021","unstructured":"Nante N, Guarducci G, Lorenzini C, Messina G, Carle F, Carbone S, Urbani A (2021) Inter-regional hospital patients\u2019 mobility in Italy. Healthcare 9(9):1182. https:\/\/doi.org\/10.3390\/healthcare9091182","journal-title":"Healthcare"},{"issue":"3","key":"809_CR41","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1177\/1071100713511606","volume":"35","author":"AJ Pugely","year":"2014","unstructured":"Pugely AJ, Lu X, Amendola A, Callaghan JJ, Martin CT, Cram P (2014) Trends in the use of total ankle replacement and ankle arthrodesis in the United States Medicare population. Foot Ankle Int 35(3):207\u2013215. https:\/\/doi.org\/10.1177\/1071100713511606","journal-title":"Foot Ankle Int"},{"key":"809_CR42","unstructured":"Italian Arthroplasty Registry (2024). https:\/\/riap.iss.it\/riap\/en\/. Accessed 17 Jul 2024"},{"issue":"4-S","key":"809_CR43","doi-asserted-by":"publisher","first-page":"31","DOI":"10.23750\/abm.v91i4-S.9725","volume":"91","author":"EM Samaila","year":"2020","unstructured":"Samaila EM, Bissoli A, Argentini E, Negri S, Col\u00f2 G, Magnan B (2020) Total ankle replacement in young patients. Acta Biomed 91(4-S):31\u201335. https:\/\/doi.org\/10.23750\/abm.v91i4-S.9725","journal-title":"Acta Biomed"},{"issue":"4","key":"809_CR44","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1053\/j.jfas.2021.10.034","volume":"61","author":"UG Longo","year":"2022","unstructured":"Longo UG, Papalia R, Bonifacini C, Martinelli N, Candela V, Ruzzini L, De Salvatore S, Piergentili I, Denaro V (2022) Emerging national trends in ankle prosthesis: a 15-year analysis of the Italian National Hospital discharge records. J Foot Ankle Surg 61(4):695\u2013699. https:\/\/doi.org\/10.1053\/j.jfas.2021.10.034","journal-title":"J Foot Ankle Surg"},{"issue":"11","key":"809_CR45","doi-asserted-by":"publisher","first-page":"3368","DOI":"10.1007\/s11999-015-4435-2","volume":"473","author":"H Malchau","year":"2015","unstructured":"Malchau H, Porter ML (2015) Editorial Comment: 2014 Meeting of The International Society of Arthroplasty Registers. Clin Orthop Relat Res 473(11):3368\u20133369. https:\/\/doi.org\/10.1007\/s11999-015-4435-2","journal-title":"Clin Orthop Relat Res"},{"key":"809_CR46","unstructured":"ODEP Orthopaedic Data Evaluation Panel. https:\/\/www.odep.org.uk\/. Accessed 6 Jul 2024."}],"container-title":["Journal of Orthopaedics and Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-024-00809-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s10195-024-00809-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-024-00809-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T19:12:10Z","timestamp":1738177930000},"score":1,"resource":{"primary":{"URL":"https:\/\/jorthoptraumatol.springeropen.com\/articles\/10.1186\/s10195-024-00809-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,29]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["809"],"URL":"https:\/\/doi.org\/10.1186\/s10195-024-00809-8","relation":{},"ISSN":["1590-9999"],"issn-type":[{"value":"1590-9999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,29]]},"assertion":[{"value":"22 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Data were anonymized and aggregated from an administrative database, and no ethics committee approval was needed under national law to conduct this study. On the basis of the large numbers used, identification of procedures undergone by individuals was assumed to be extremely low. The study was conducted following the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}