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
Abstract Background 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 years (2001–2022) in Italy, analyzing the distributions of hospitals by volume of activity and patients...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-01-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-024-00809-8 |
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| author | Adriano Cuccu Elena Manuela Samaila Enrico Ciminello Umberto Alfieri Montrasio Fabrizio Cortese Stefania Ceccarelli Tiziana Falcone Marina Torre |
| author_facet | Adriano Cuccu Elena Manuela Samaila Enrico Ciminello Umberto Alfieri Montrasio Fabrizio Cortese Stefania Ceccarelli Tiziana Falcone Marina Torre |
| author_sort | Adriano Cuccu |
| collection | DOAJ |
| description | Abstract Background 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 years (2001–2022) 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. Materials and methods 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–Stuart test with randomness as a null hypothesis. Results 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 (p < 0.05), while the number of fusions exhibited a stationary behavior (p > 0.05). The increased trend in TAR procedures was concentrated mostly in the North of Italy, with predominantly males between 55 and 64 years 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. Conclusions 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’ participation in data collection. Level of evidence: population based study, level 1 evidence. |
| format | Article |
| id | doaj-art-dcbaabae42734dc4b3ceed43b8dc0a5c |
| institution | Kabale University |
| issn | 1590-9999 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj-art-dcbaabae42734dc4b3ceed43b8dc0a5c2025-02-02T12:36:35ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992025-01-0126111210.1186/s10195-024-00809-8Is 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 databaseAdriano Cuccu0Elena Manuela Samaila1Enrico Ciminello2Umberto Alfieri Montrasio3Fabrizio Cortese4Stefania Ceccarelli5Tiziana Falcone6Marina Torre7Italian National Registry of Implantable Prostheses (RIPI), Italian National Institute of HealthDepartment of Orthopaedics and Trauma Surgery, University of Verona, Piazzale L. A. ScuroItalian National Registry of Implantable Prostheses (RIPI), Italian National Institute of HealthIRCCS Galeazzi-Sant’Ambrogio HospitalOrthopaedic and Traumatology Unit, Santa Maria del Carmine HospitalItalian National Registry of Implantable Prostheses (RIPI), Italian National Institute of HealthItalian National Registry of Implantable Prostheses (RIPI), Italian National Institute of HealthItalian National Registry of Implantable Prostheses (RIPI), Italian National Institute of HealthAbstract Background 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 years (2001–2022) 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. Materials and methods 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–Stuart test with randomness as a null hypothesis. Results 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 (p < 0.05), while the number of fusions exhibited a stationary behavior (p > 0.05). The increased trend in TAR procedures was concentrated mostly in the North of Italy, with predominantly males between 55 and 64 years 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. Conclusions 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’ participation in data collection. Level of evidence: population based study, level 1 evidence.https://doi.org/10.1186/s10195-024-00809-8Total ankle replacementAnkle fusionRegistryEpidemiologyPublic health |
| spellingShingle | Adriano Cuccu Elena Manuela Samaila Enrico Ciminello Umberto Alfieri Montrasio Fabrizio Cortese Stefania Ceccarelli Tiziana Falcone Marina Torre 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 Journal of Orthopaedics and Traumatology Total ankle replacement Ankle fusion Registry Epidemiology Public health |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Total ankle replacement Ankle fusion Registry Epidemiology Public health |
| url | https://doi.org/10.1186/s10195-024-00809-8 |
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