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- Talk
- 21/09/2022
- UK
A Cohort Study of Risk Factors for Failure of Total Ankle Replacements: A Data Linkage Study Using The National Joint Registry and NHS Digital
Description
Toby Jennison presents a detailed examination of ankle replacements and their risk factors for failure. He notes the stark difference in the frequency of hip replacements (about 100,000 annually) compared to ankle replacements (around 1,000) and emphasizes the relative infancy of ankle replacement knowledge and its outcomes. Jennison highlights the limited data and studies available on ankle replacements, making it challenging to identify ideal candidates for the procedure. He discusses the consequences of failed procedures, including the possibility of fusion, revision, or amputation, underscoring the concern from organizations like NJR and BOFAS regarding the underreporting of these failures.
The primary aim of his research was to analyze the risk factors associated with ankle replacement failure using NJR and NHS Digital data from 2010 to 2019. He conducted a data linkage study that revealed discrepancies in reported survivorship; the NJR data suggested a 98.8% one-year survival but showed lower rates in the linked data, indicating that failures may be more prevalent than reported.
Jennison identifies several significant risk factors influencing the outcome of ankle replacements, with increasing age, higher BMI, and osteoarthritis being particularly correlated with increased failure rates. For example, he details how older patients and those with obesity are at greater risk of revision surgeries. A comparative analysis of the survivorship rates shows that younger, healthier patients tend to have better outcomes.
He concludes that while younger age and elevated BMI are critical risk factors for failure, this should not deter medical professionals from performing ankle replacements on these patients, but rather inform them of the associated risks. The study reveals that a third of failures may not be self-reported, advocating for more accurate monitoring of such procedures. Jennison expresses gratitude towards the NJR and the Gwen Fish Orthopedic Trust for their support, followed by an appreciative applause from the audience.