Logistic regression of predictors of reoperation following primary total ankle replacement
| Revision | Arthroscopy | Bone debridement | Calcaneal osteotomy | Ligamentous operation | wound related | removal of metal work | subtalar fusion | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | |
| Indication | ||||||||||||||||
| Osteoarthritis | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Rheumatoid | 1.2 (0.5 to 2.5) | 0.11 | 1.3 (0.5 to 3.2) | 0.51 | 2.5 (0.8 to 6) | 0.007 | 4.2 (0.3 to NA) | 0.99 | 0.024 (NA) | 0.99 | 2.2 (1.1-4.3) | 0.028 | 2.2 (1.2-3.9) | 0.006 | 1.7 (0.6-3.8) | 0.23 |
| Inflammatory | 2.2 (0.6 to 5) | 0.78 | 0.02 (0.001 to 7.3) | 0.98 | 0.04 (0.001 to 82) | 0.99 | 2.6 (0.1 to NA) | 0.99 | 0.025 (NA) | 0.99 | 0.04 (NA) | 0.99 | 2.6 (0.8-6.4) | 0.07 | 0.05 (NA) | 0.99 |
| Other | 0.03 (NA) | 0.99 | 0.03 (0.01 to 5.30) | 0.97 | 1.3 (0.5 to 2.7) | 0.5 | 2.6 (0.1 to NA) | 0.99 | 0.026 (NA) | 0.99 | 1.6 (0.9-2.8) | 0.08 | 2.1 (0.7-5) | 0.11 | 0.05 (NA) | 0.99 |
| Operation type | ||||||||||||||||
| Uncemented | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Cemented | 0.05 (NA) | 0.99 | 1.8 (NA) | 0.99 | 0.04 (NA to 77) | 0.99 | 2.3 (NA) | 0.99 | 4.5 (1.1 to 14) | 0.02 | 6.1 (1.3-31) | 0.01 | 0.03 (NA) | 0.99 | 0.05 (NA) | 0.97 |
| Hybrid | 2.4 (0.7 to 6.1) | 0.11 | 1.5 (NA) | 0.98 | 0.04 (NA to 77) | 0.99 | 6.4 (NA) | 0.99 | 0.03 (NA) | 0.99 | 0.02 (NA) | 0.99 | 0.02 (NA) | 0.99 | 0.05 (NA) | 0.95 |
| Approach to ankle | ||||||||||||||||
| Anterior | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Ant-lat | 0.03 (NA) | 0.99 | 1.04 (0.02 to 4.4) | 0.99 | 0.9 (0.02 to 7.3) | 0.99 | 7 (0.1 to NA) | 0.99 | 0.3 (NA) | 0.99 | 0.07 (NA) | 0.99 | 0.22 (NA) | 0.99 | 0.42 (NA) | 0.99 |
| Lateral | 0.03(NA) | 0.99 | 1.7 (NA) | 0.99 | 0.02 (0.001 to 68) | 0.99 | 1.45 (0.1 to NA) | 0.99 | 0.3 (NA) | 0.99 | 1.2 (1.01-7.6) | 0.025 | 0.22 (NA) | 0.99 | 0.42 (NA) | 0.94 |
| Organisation | ||||||||||||||||
| NHS | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Ind. hosp | 1.02 (0.4 to 2.1) | 0.96 | 1.9 (0.6 to 4) | 0.18 | 1.5 (0.05 to 3.3) | 0.4 | 0.99 (0.1 to NA) | 0.99 | 1.5 (0.5 to 3.3) | 0.99 | 0.02 (NA) | 0.99 | 0.23 (NA) | 0.99 | 0.035 (NA) | 0.94 |
| ITC | 1.1 (0.4 to 2.4) | 0.76 | 2 (1.01 to 4.4) | 0.05 | 0.02 (0.001 to 23) | 0.99 | 1.1 (0.6 to NA) | 0.99 | 0.03 (0.001-15) | 0.99 | 0.01 (NA) | 0.99 | 0.22 (NA) | 0.99 | 0.035 (NA) | 0.95 |
| Unit volume | ||||||||||||||||
| >20 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| <20 | 1.6 (1.1 to 2.5) | 0.04 | 1.2 (0.7 to 2.1) | 0.6 | 0.9 (0.5 to 1.7) | 0.716 | 0.47 (0.01 to 9.6) | 0.99 | 0.9 (0.5-1.6) | 0.69 | 1.1 (0.7-1.6) | 0.74 | 0.52 (0.2-0.9) | 0.062 | 0.03 (NA) | 0.91 |
| Pre-op deformity | ||||||||||||||||
| Neu | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Valgus | 0.03 (NA) | 0.99 | 0.16 (0.001 to 13) | 0.99 | 0.03 (0.001 to 14) | 0.99 | 7.8 (0.5 to NA) | 0.99 | 0.33 (NA) | 0.99 | 0.03 (NA) | 0.99 | 1.8 (0.8-3.6) | 0.14 | 1.9 (0.6-5.3) | 0.2 |
| Varus | 1.2 (0.4 to 2.6) | 0.66 | 0.6 (0.3 to 4.4) | 0.71 | 0.03 (0.004 to 45) | 0.99 | 1 (0.1 to 74) | 0.99 | 0.33 (NA) | 0.99 | 1.6 (0.8-2.8) | 0.14 | 1.2 (0.4-2.7) | 0.63 | 1.7 (0.6-4.8) | 0.3 |
| Pre-op dorsiflexion | ||||||||||||||||
| 5–10 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Neu | 1.7 (0.7 to 4.8) | 0.23 | 1.02 (0.6 to 1.7) | 0.922 | 0.03 (0.002 to 15) | 0.99 | 1 (0.2 to 51) | 0.99 | 1.1 (0.4 to 2.2) | 0.89 | 0.9 (0.5 to 1.4) | 0.6 | 0.5 (0.2 to 0.9) | 0.06 | 0.03 (NA) | 0.99 |
| Fixed eq | 3.53 (1.1 to 12) | 0.026 | 1.9 (1.3 to 3.3) | 0.03 | 1.7 (0.8 to 4.7) | 0.23 | 1 (0.4 to 43) | 0.99 | 0.6 (0.2 to 1.2) | 0.22 | 0.91 (0.3 to 1.8) | 0.81 | 0.8 (0.3 to 1.6) | 0.54 | 0.8 (0.3 to 1.8) | 0.61 |
| Pre-op plantarflexion | ||||||||||||||||
| 16–45 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| 5–15 | 1.04 (0.3 to 4) | 0.95 | 2.1 (1.1 to 4.9) | 0.037 | 4.5 (0.8 to 45) | 0.99 | 1 (NA) | 0.98 | 3.6 (0.6 to 6.8) | 0.25 | 3.04 (0.8 to 20) | 0.16 | 0.8 (0.5 to 1.3) | 0.35 | 0.34 (0.01 to 3.5) | 0.4 |
| Number of associated procedures | ||||||||||||||||
| 0 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| 1 | 0.6 (0.2 to 1.2) | 0.2 | 0.1 (0.02 to 5.4) | 0.99 | 0.9 (0.1 to 32) | 1 | 1.4 (0.6 to 3.3) | 0.4 | 1.4 (0.7 to 12) | 0.9 | 0.9 (0.1 to 5.6) | 0.9 | 1.6 (0.8 to 3) | 0.1 | 0.8 (0.01 to 16) | 0.9 |
| 2 | 1.5 (0.1 to 7.2) | 0.9 | 0.2 (0.1 to 7.4) | 0.99 | 0.9 (0.1 to 23) | 1 | 2.4 (0.2 to 22) | 0.9 | 2.3 (0.6 to 6.9) | 0.1 | 5.2 (1.5 to 36) | 0.9 | 1.8 (0.4 to 5) | 0.8 | 0.7 (0.1 to 9.6) | 0.9 |
| 3 | 0.2 (NA) | 0.9 | 0.1 (0.01 to 13) | 1 | 1.1 (0.3 to 15) | 1 | 2.9 (0.4 to 4.4) | 0.8 | 1 (0.1 to 9.8) | 0.9 | 6.6 (0.4 to 9.1) | 0.9 | 1.2 (0.4 to 3.1) | 0.9 | 1.1 (0.7 to 6.8) | 0.9 |
| Type of associated procedure | ||||||||||||||||
| None | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| Subtalar fusion | 0.2 (0.1 to 14) | 0.95 | 0.02 (0.01—14) | 0.99 | 1.5 (0.01 to NA) | 1 | 0.2 (0.1 to 6.7) | 0.97 | 0.03 (0.01 to 78) | 0.99 | 2 (1.1 to 3.8) | 0.04 | 1.7 (0.8 to 3.3) | 0.1 | 0.04 (NA to 26) | 0.99 |
| Talonavicular fusion | 2 (0.1 to 4.6) | 0.97 | 0.02 (0.001 to 17) | 0.96 | 1.1 (0.01 to 23) | 0.89 | 0.2 (0.01 to 12) | 0.98 | 0.04 (NA to 35) | 0.98 | 2.8 (1.2 to 5.8) | 0.01 | 0.04 (NA to 9.4) | 0.98 | 0.05 (NA to 35) | 0.99 |
| Calcaneal osteotomy | 0.5 (0.1 to 12) | 0.97 | 0.01 (0.001 to 9) | 0.99 | 1.4 (0.7 to 25) | 0.9 | 1.9 (0.1 to 16) | 0.98 | 1.5 (0.5 to 3.3) | 0.36 | 1.7 (0.5 to 3.9) | 0.3 | 0.03 (NA to 24) | 0.99 | 0.04 (NA to 27) | 0.99 |
| Lengthening of achilles | 1.1 (0.4 to 2.5) | 0.8 | 0.02 (0.01 to 11) | 0.97 | 0.8 (0.4 to NA) | 1 | 2 (0.4 to 32) | 0.96 | 1.2 (0.6 to 2.2) | 0.5 | 1.1 (0.4 to 2.1) | 0.96 | 0.9(0.4 to 1.9) | 0.89 | 0.03 (NA to 13) | 0.99 |
| Fusion distal tibiofibular joint | 1.8 (0.2 to 19) | 1 | 0.01 (NA to 23) | 1 | 0.1 (NA) | 1 | 0.2 (NA) | 1 | 0.06 (NA to 31) | 0.99 | 0.02(NA to 21) | 0.99 | 0.09 (NA to 57) | 0.99 | 0.09 (NA to 19) | 0.99 |
| Fibula osteotomy | 0.2 (0.01 to NA) | 0.99 | 0.02 (0.001 to 31) | 0.93 | 0.9 (NA) | 1 | 0.2 (0.01 to NA) | 0.99 | 5 (1.3 to 18) | 0.02 | 0.06 (NA to 11) | 0.98 | 0.05(NA to 44) | 0.99 | 0.07 (NA to 43) | 0.94 |
| Medial malleolar osteotomy | 0.03 (0.002 to 15) | 0.99 | 0.01 (NA to 12) | 0.99 | 0.9 (NA) | 1 | 0.2 (0.03 to NA) | 0.99 | 3.3 (0.9 to 9.8) | 0.06 | 0.03 (0.001 to 13) | 0.97 | 0.04 (NA to 38) | 0.99 | 0.06 (NA to 20) | 0.99 |
| Lateral ligament recon | 0.3 (0.1 to 22) | 0.7 | 0.02 (0.01 to 34) | 0.99 | 1.3 (0.01 to NA) | 1 | 5 (1.2 to 17) | 0.017 | 0.04 (0.01 to 35) | 0.98 | 0.05(0.01 to 35) | 0.98 | 0.04 (NA to 19) | 0.99 | 0.06 (NA to 25) | 0.94 |
| Medial ligament recon | 1.7 (0.6 to 11) | 0.99 | 0.01 (NA to 23) | 1 | 1 (0.01 to NA) | 1 | 0.2 (0.01 to NA) | 0.99 | 0.05 (NA to 13) | 0.98 | 0.05 (0.01 to 55) | 0.92 | 0.04 (NA to 10) | 0.99 | 0.06 (NA to 98) | 0.99 |
Adjusted for age, gender and comorbidity.
ITC, Independent Treatment Centre.