The mortality rate and clinical outcomes of ankle arthroplasty in Scotland from 2000 to 2023

Patrick Porter, Matthew Kennedy, Andrew Brunt, Jon V Clarke, Phil Walmsley

Introduction: An ankle arthroplasty is a definitive treatment for end-stage arthritis. This is a commonly performed operation, however, there is limited evidence on arthroplasty survival, clinical outcome and comparison of various implants used in Scotland. The primary aim of this study is to determine the survivorship of arthroplasty, the length of patient hospital stay and mortality rate. Method: This retrospective cohort study was comprised of multi-centre data from the Scottish Arthroplasty Project (SAP) between 2000 to 2023. Demographic and clinical data was collected prospectively. The primary outcome of arthroplasty failure was defined: as the removal or exchange of any components of the implanted device including removal of the polyethene, one stage or two stage revision or conversion to ankle fusion. Results: A total of 1517 ankle arthroplasties were included in this study in 2000. A total of 1196 patients were alive by the end of the study in 2023. This gives mortality rate of 21.16%. A total of 127 ankle arthroplasties failed (9.14%), meaning revision surgery was required. The arthroplasty survival at 23 years, using revision surgery as an end point, was 73.96%. The median length of hospital stay was two days. The mean infection rate of an ankle arthroplasty was 1.25%. Conclusions: The ankle arthroplasty survival rate in Scotland is in keeping with the rate of the UK."