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Foot & Ankle

Patient-related risk factors associated with poorer outcomes following total ankle arthroplasty

a scoping review of 101,552 cases

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This scoping review aims to identify patient-related factors associated with a poorer outcome following total ankle arthroplasty (TAA).


A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A computer-based literature search was performed in PubMed, Embase, Cochrane trials, and Web of Science. Two reviewers independently performed title/abstract and full-text screening according to predetermined selection criteria. English-language original research studies reporting patient-related factors associated with a poorer outcome following TAA were included. Outcomes were defined as patient-reported outcome measures (PROMs), perioperative complications, and failure.


A total of 94 studies reporting 101,552 cases of TAA in 101,177 patients were included. The most common patient-related risk factor associated with poorer outcomes were younger age (21 studies), rheumatoid arthritis (17 studies), and diabetes (16 studies). Of the studies using multivariable regression specifically, the most frequently described risk factors were younger age (12 studies), rheumatoid arthritis (eight studies), diabetes (eight studies), and high BMI (eight studies).


When controlling for confounding factors, the most commonly reported risk factors for poor outcome are younger age, rheumatoid arthritis, and comorbidities such as diabetes and increased BMI. These patient-related risk factors reported may be used to facilitate the refinement of patient selection criteria for TAA and inform patient expectations.

Cite this article: Bone Joint J 2023;105-B(9):985–992.

Correspondence should be sent to Dr Zaki Arshad. E-mail:

Z. Arshad and I. I. Haq contributed equally to this work.

Z. Arshad and I. I. Haq are joint first authors.

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