{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:18:07Z","timestamp":1787753887481,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Obesity rates continue to rise worldwide. Current evidence for total ankle replacement (TAR) in obese patients is conflicting, limited to short-term to mid-term follow-up. Therefore, the aim of this study was to assess long-term outcomes of obese versus nonobese TAR patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study was undertaken at a quaternary institution. Groups were defined by body mass index (BMI) (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ): \u226530 (obese) or &lt;30 (nonobese). Primary outcome measures included the Ankle Osteoarthritis Scale (AOS) and Short-Form 36 (SF-36). Secondary outcomes described secondary procedures following TAR. Multivariable linear regression was completed for patient-reported outcomes measures (PROMs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included 515 TARs in 482 patients (236 ankles obese, 279 ankles nonobese) with a mean age of 64 years and mean follow-up of 13.2 years. 310 TARs had minimum 10-year PROMs follow-up for analysis. No statistically significant differences in AOS pain\/disability and SF-36 Physical Component Summary\/Mental Component Summary changes scores (preoperative to latest follow-up) were observed between the 2 cohorts. Obese patients had statistically worse AOS disability scores preoperatively (p = 0.01), while disability levels were comparable postoperatively. Multivariable linear regression analysis revealed BMI \u226530 was not associated with poorer outcomes when adjusting for age, sex, implant, preoperative PROM score, follow-up duration, arthritis etiology, or diabetes. The number of patients undergoing secondary procedures and the number of secondary procedures required between cohorts were similar (34.4% obese TARs vs. 37.6% nonobese TARs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>TARs can be successfully undertaken in obese patients with long-term improvement in PROMs and no significant increase in incidence of secondary procedures similar to their nonobese counterparts. These findings challenge the perception of obesity as a relative contraindication to TAR and support its use in appropriately selected obese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.26.00054","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T18:00:26Z","timestamp":1776189626000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Total Ankle Replacement Outcomes in Obese Patients with Minimum 10-Year Follow-Up"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-8363","authenticated-orcid":false,"given":"Zakir","family":"Haider","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7240-2581","authenticated-orcid":false,"given":"Ellie","family":"Pinsker","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Unity Health Toronto - 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