Tibio-tarsal arthrodesis in Italy: Results from an epidemiological 16-year nationwide study

Purpose: The goal of this study was to assess the annual incidence of tibiotarsal arthrodesis in Italy and the epidemiological characteristics of patients requiring surgery. A secondary aim was to assess the economic impact of this type of surgery on the healthcare system. Methods: The analysis was conducted by using the National Hospital Discharge Records (NHDR) database provided by the Italian Ministry of Health. Results: 8380 tibiotarsal arthrodeses were performed in Italy. One procedure per 100,000 adult Italians was the cumulative incidence. The age group of 60–64 years required the highest number of procedures. Males represented the majority of patients undergoing surgery (59.6%). The median length of hospital stay was 7.3 ± 10.8 days. On average, older patients had more days of hospitalization. Main primary diagnosis codes according to the ICD-9-CM were: 715.27 (17.5%); 905.4 (15.8%); 715.17 (11.7%); 716.17 (5.1%); 733.82 (3.9%); 718.47 (3.4%). The admission reimbursement in Italy ranges from 1887€ to 4405€ depending on the length of stay. In 16 years, a total expenditure of 36,803,844€ was projected. The procedure in Italy costed an average of 2,300,240 ± 373,514€ per year. Conclusions: The socioeconomic impact of tibiotarsal arthrodesis in Italy is relevant. Between 2001 and 2016, the frequency of this procedure progressively rose. Patients undergoing surgery in Italy are mainly men, still active and part of the working population. Nationwide epidemiologic studies are useful to understand the present and future development of the management of ankle diseases. Level of Evidence: Level III.