Learning curve of total ankle arthroplasty: a systematic review

Introduction Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evalu...

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Published inArchives of orthopaedic and trauma surgery Vol. 144; no. 2; pp. 591 - 600
Main Authors Arshad, Zaki, Haq, Ibrahim Inzarul, Bhatia, Maneesh
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2024
Springer Nature B.V
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Abstract Introduction Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evaluate the effect of a learning curve in total ankle arthroplasty outcomes. Methods An electronic database search was performed in PubMed, Embase, ISI Web of Science and Cochrane trials. Two reviewers independently conducted a two-stage title/abstract and full text screening. English-language original research studies comparing patient-reported outcome measures (PROMs), complication/revision rates, operative time, length of stay or radiation exposure according to surgeon experience were included. Quality assessment was performed using the methodological index for non-randomised studies. Results All but one included study report either improved PROMs, reduced complication/revision rate, reduced hospital stay length/operative time or reduced radiation exposure with increasing surgeon experience. However, the majority of these findings lack statistical significance. Two studies assessing the plateau of the learning curve report a wide range of plateau thresholds between 9 and 39 cases. Conclusion This review finds a largely non-significant trend towards improvements in PROMs, complication, and revision rates with improved surgeon experience. The lack of statistical significance in a number of studies may be partially explained by methodological flaws, with more suitably designed studies reporting significant improvements. Future research into the effect of advancements in implant design and insertion guides is required to further characterise the magnitude of the learning curve and guide both mitigation and learning strategies.
AbstractList Introduction Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evaluate the effect of a learning curve in total ankle arthroplasty outcomes. Methods An electronic database search was performed in PubMed, Embase, ISI Web of Science and Cochrane trials. Two reviewers independently conducted a two-stage title/abstract and full text screening. English-language original research studies comparing patient-reported outcome measures (PROMs), complication/revision rates, operative time, length of stay or radiation exposure according to surgeon experience were included. Quality assessment was performed using the methodological index for non-randomised studies. Results All but one included study report either improved PROMs, reduced complication/revision rate, reduced hospital stay length/operative time or reduced radiation exposure with increasing surgeon experience. However, the majority of these findings lack statistical significance. Two studies assessing the plateau of the learning curve report a wide range of plateau thresholds between 9 and 39 cases. Conclusion This review finds a largely non-significant trend towards improvements in PROMs, complication, and revision rates with improved surgeon experience. The lack of statistical significance in a number of studies may be partially explained by methodological flaws, with more suitably designed studies reporting significant improvements. Future research into the effect of advancements in implant design and insertion guides is required to further characterise the magnitude of the learning curve and guide both mitigation and learning strategies.
Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evaluate the effect of a learning curve in total ankle arthroplasty outcomes. An electronic database search was performed in PubMed, Embase, ISI Web of Science and Cochrane trials. Two reviewers independently conducted a two-stage title/abstract and full text screening. English-language original research studies comparing patient-reported outcome measures (PROMs), complication/revision rates, operative time, length of stay or radiation exposure according to surgeon experience were included. Quality assessment was performed using the methodological index for non-randomised studies. All but one included study report either improved PROMs, reduced complication/revision rate, reduced hospital stay length/operative time or reduced radiation exposure with increasing surgeon experience. However, the majority of these findings lack statistical significance. Two studies assessing the plateau of the learning curve report a wide range of plateau thresholds between 9 and 39 cases. This review finds a largely non-significant trend towards improvements in PROMs, complication, and revision rates with improved surgeon experience. The lack of statistical significance in a number of studies may be partially explained by methodological flaws, with more suitably designed studies reporting significant improvements. Future research into the effect of advancements in implant design and insertion guides is required to further characterise the magnitude of the learning curve and guide both mitigation and learning strategies.
INTRODUCTIONTogether with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle. The evidence regarding how outcomes are affected by surgeon experience is inconsistent; we performed a systematic review to evaluate the effect of a learning curve in total ankle arthroplasty outcomes.METHODSAn electronic database search was performed in PubMed, Embase, ISI Web of Science and Cochrane trials. Two reviewers independently conducted a two-stage title/abstract and full text screening. English-language original research studies comparing patient-reported outcome measures (PROMs), complication/revision rates, operative time, length of stay or radiation exposure according to surgeon experience were included. Quality assessment was performed using the methodological index for non-randomised studies.RESULTSAll but one included study report either improved PROMs, reduced complication/revision rate, reduced hospital stay length/operative time or reduced radiation exposure with increasing surgeon experience. However, the majority of these findings lack statistical significance. Two studies assessing the plateau of the learning curve report a wide range of plateau thresholds between 9 and 39 cases.CONCLUSIONThis review finds a largely non-significant trend towards improvements in PROMs, complication, and revision rates with improved surgeon experience. The lack of statistical significance in a number of studies may be partially explained by methodological flaws, with more suitably designed studies reporting significant improvements. Future research into the effect of advancements in implant design and insertion guides is required to further characterise the magnitude of the learning curve and guide both mitigation and learning strategies.
Author Haq, Ibrahim Inzarul
Arshad, Zaki
Bhatia, Maneesh
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  fullname: Bhatia, Maneesh
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Cites_doi 10.2106/JBJS.N.00837
10.1016/j.arthro.2013.11.012
10.1177/1071100716655435
10.1080/17453670710014248
10.1177/1071100717735288
10.1302/0301-620X.101B1.BJJ-2018-0801.R1
10.1016/j.fcl.2017.01.010
10.1302/0301-620X.101B6.BJJ-2018-1678.R1
10.1302/0301-620X.104B4.BJJ-2021-0167.R5
10.3109/17453671003685459
10.1016/j.fas.2020.03.005
10.1053/j.jfas.2006.02.013
10.2106/00004623-200406000-00008
10.1046/j.1445-2197.2003.02748.x
10.1186/s13643-016-0384-4
10.1177/10711007221077100
10.1302/2058-5241.3.170029
10.1302/0301-620X.96B12.34364
10.1177/1071100712467430
10.1302/0301-620X.103B4.BJJ-2020-0758.R1
10.1016/j.fas.2016.02.007
10.1177/1071100713518187
10.1016/j.fas.2006.06.002
10.1177/107110070302400612
10.1177/1071100715606477
10.1016/j.fas.2018.11.007
10.1007/s00264-021-05145-8
10.2106/JBJS.21.00746
10.1016/j.jos.2022.05.008
10.1302/0301-620X.95B11.31633
10.1016/j.arth.2020.07.045
10.1302/0301-620X.102B7.BJJ-2019-1263.R2
10.1177/1938640020950156
10.1177/19386400221110133
10.1177/0363546517749219
10.1177/1938640013493463
10.1302/0301-620X.103B7.BJJ-2020-2058.R2
10.5435/JAAOS-D-17-00526
10.1093/mr/roac123
10.1136/bmj.n160
10.1016/j.arthro.2014.02.021
10.2106/JBJS.20.00395
10.1016/j.foot.2018.07.001
10.1177/1071100721996379
10.2106/JBJS.L.01597
10.1053/j.jfas.2012.10.009
10.2106/JBJS.N.01077
10.1177/1071100720985292
10.3113/FAI.2008.0978
10.1177/107110070302400102
10.1530/EOR-21-0117
10.5435/JAAOS-D-21-00232
10.1177/107110070402500502
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Issue 2
Keywords Ankle
Surgeon experience
Arthritis
Ankle replacement
Ankle arthroplasty
Learning curve
Language English
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References Page MJ, Moher D, Bossuyt PM, et al (2021) PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ n160. https://doi.org/10.1136/bmj.n160
Clough TM, Ring J (2021) Total ankle arthroplasty. Bone Joint J 103-B:696–703. https://doi.org/10.1302/0301-620X.103B4.BJJ-2020-0758.R1
DanielsTRYoungerASEPennerMIntermediate-term results of total ankle replacement and ankle arthrodesis A COFAS multicenter studyJ Bone Jt Surg-Am201496A13514210.2106/JBJS.L.01597
KumarADharSTotal ankle replacement: Early results during learning periodFoot Ankle Surg200713192310.1016/j.fas.2006.06.002
LampleyAGrossCEGreenCLAssociation of cigarette use and complication rates and outcomes following total ankle arthroplastyFOOT ANKLE Int2016371052105910.1177/107110071665543527344053
YangHYWangSHLeeKBThe HINTEGRA total ankle arthroplasty functional outcomes and implant survivorship in 210 osteoarthritic ankles at a mean of 6.4 yearsBone Joint J2019101B69570110.1302/0301-620X.101B6.BJJ-2018-1678.R1
FletcherANModyKSAdamsSBEffect of gender differences on patient-reported outcomes and complications in total ankle replacementFoot Ankle Int20214277678710.1177/107110072098529233517772
TadaMInuiKOkanoTKoikeTComparison of clinical and radiographic results of mobile-bearing total ankle arthroplasty between osteoarthritis and rheumatoid arthritisMod Rheumatol202210.1093/mr/roac12334918141
Hoppe DJ, de SA D, Simunovic N, et al (2014) The learning curve for hip arthroscopy: a systematic review. Arthrosc J Arthrosc Relat Surg 30:389–397. https://doi.org/10.1016/j.arthro.2013.11.012
GrossCELampleyAGreenCLThe effect of obesity on functional outcomes and complications in total ankle arthroplastyFoot Ankle Int20163713714110.1177/107110071560647726377200
Townshend DN, Bing AJF, Clough TM, et al (2021) Early experience and patient-reported outcomes of 503 INFINITY total ankle arthroplasties. Bone Joint J 103-B:1270–1276. https://doi.org/10.1302/0301-620X.103B7.BJJ-2020-2058.R2
LeeKBChoSGHurCIYoonTRPerioperative complications of HINTEGRA total ankle replacement: Our initial 50 casesFoot Ankle Int20082997898410.3113/FAI.2008.097818851813
SpirtAAAssalMHansenSTComplications and failure after total ankle arthroplastyJ Bone Jt Surgery-Am200486A1172117810.2106/00004623-200406000-00008
HodginsJLVeilletteCBiauDSonnadaraRThe knee arthroscopy learning curve: quantitative assessment of surgical skillsArthrosc J Arthrosc Relat Surg20143061362110.1016/j.arthro.2014.02.021
ClementRKrynetskiyRSG P, The total ankle arthroplasty learning curve with third-generation implants: a single surgeon’s experienceFoot Ankle Spec2013626327010.1177/193864001349346323811949
SlimKNiniEForestierDMethodological index for non-randomized studies (Minors): development and validation of a new instrumentANZ J Surg200310.1046/j.1445-2197.2003.02748.x12956787
BouchardMAminAPinskerEThe impact of obesity on the outcome of total ankle replacementJ BONE Jt SURGERY-AMERICAN201597A90491010.2106/JBJS.N.00837
HaskellAMannRAPerioperative complication rate of total ankle replacement is reduced by surgeon experienceFoot Ankle Int20042528328910.1177/10711007040250050215134607
Herrera-PérezMValderrabanoVGodoy-SantosALAnkle osteoarthritis: comprehensive review and treatment algorithm proposalEFORT Open Rev2022744845910.1530/EOR-21-0117359002109297055
Johnson-LynnSERamaskandhanJSiddiqueMSThe effect of patient age and diagnosis on the 5-year outcomes of mobile-bearing total ankle replacementFoot (Edinb)201836151:STN:280:DC%2BB3c7htValuw%3D%3D10.1016/j.foot.2018.07.00130036683
UsuelliFGMaccarioCPantaloneAIdentifying the learning curve for total ankle replacement using a mobile bearing prosthesisFoot Ankle Surg201723768310.1016/j.fas.2016.02.00728578798
CunninghamDJSteeleJRAllenNBThe impact of preoperative mental health and depression on outcomes after total ankle arthroplastyJ Bone Jt Surgery-Am202110313113810.2106/JBJS.20.00395
SteinBSomersonJJanneyCPanchbhaviVDistribution of high-volume ankle replacement surgeons in United States metropolitan areasFoot Ankle Spec20221512713510.1177/193864002095015632819156
HenricsonASkoogACarlssonAThe Swedish ankle arthroplasty register - An analysis of 531 arthroplasties between 1993 and 2005ACTA Orthop20077856957410.1080/1745367071001424817966014
DagneauxLNogueEMathieuJSurvivorship of 4,748 contemporary total ankle replacements from the french discharge records databaseJ Bone Jt Surg-Am202210468469210.2106/JBJS.21.00746
Schimmel JJP, Walschot LHB, Louwerens JWK, et al (2014) Comparison of the short-term results of the first and last 50 scandinavian total ankle replacements: Assessment of the learning curve in a consecutive series. Foot Ankle Int 35:326–333. https://doi.org/10.1177/1071100713518187
EscuderoMILeVBemenderferTBTotal ankle arthroplasty radiographic alignment comparison between patient-specific instrumentation and standard instrumentationFoot Ankle Int20214285185810.1177/107110072199637933749342
ChoiWJLeeJSLeeMThe impact of diabetes on the short- to mid-term outcome of total ankle replacementBone Joint J201496B1674168010.1302/0301-620X.96B12.34364
KurokawaHTaniguchiAMiyamotoTTanakaYWhat is the best way for an inexperienced surgeon to learn total ankle arthroplasty?J Orthop Sci Off J Jpn Orthop Assoc202210.1016/j.jos.2022.05.008
SchuberthJMPatelSZarutskyEPerioperative complications of the Agility total ankle replacement in 50 initial, consecutive casesJ Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg20064513914610.1053/j.jfas.2006.02.013
SkyttaETKoivuHEskelinenATotal ankle replacement: a population-based study of 515 cases from the finnish arthroplasty registerACTA Orthop20108111411810.3109/17453671003685459201807202856214
OuzzaniMHammadyHFedorowiczZElmagarmidARayyan-a web and mobile app for systematic reviewsSyst Rev201610.1186/s13643-016-0384-4279192755139140
BleazeySTBrigidoSAProtzmanNMPerioperative complications of a modular stem fixed-bearing total ankle replacement with intramedullary guidanceJ Foot Ankle Surg201352364110.1053/j.jfas.2012.10.00923153782
Paracha N, Idrizi A, Gordon AM, et al (2022) Utilization Trends of Total Ankle Arthroplasty and Ankle Fusion for Tibiotalar Osteoarthritis: A Nationwide Analysis of the United States Population. Foot Ankle Spec 19386400221110132. https://doi.org/10.1177/19386400221110133
UsuelliFGMaccarioCPearls and pitfalls for a surgeon new to ankle replacementsFoot Ankle Clin20172247748910.1016/j.fcl.2017.01.01028502359
DanielsTRMayichDJPennerMJIntermediate to Long-Term Outcomes of Total Ankle Replacement with the Scandinavian Total Ankle Replacement (STAR)J Bone Jt Surg-Am201597A89590310.2106/JBJS.N.01077
WangQZhangNGuoWPatient-specific instrumentation (PSI) in total ankle arthroplasty: a systematic reviewInt Orthop2021452445245210.1007/s00264-021-05145-834345975
MyersonMSMroczekKPerioperative complications of total ankle arthroplastyFoot Ankle Int200324172110.1177/10711007030240010212540076
LeeKTLeeYKYoungKWPerioperative complications and learning curve of the mobility total ankle systemFoot ANKLE Int20133421021410.1177/107110071246743023413059
CloughTBodoKMajeedHSurvivorship and long-term outcome of a consecutive series of 200 Scandinavian total ankle replacement (STAR) implantsBone Joint J2019101B475410.1302/0301-620X.101B1.BJJ-2018-0801.R1
ZaidiRCroSGurusamyKThe outcome of total ankle replacement a systematic review and meta-analysisBone Joint J201395B1500150710.1302/0301-620X.95B11.31633
HeislerLVachWKatzGPatient-specific instrumentation vs standard referencing in total ankle arthroplasty: a comparison of the radiologic outcomeFoot Ankle Int20224374174910.1177/10711007221077100352097259168897
MaccarioCPaoliTRomanoFTransfibular total ankle arthroplastyBone Joint J2022104B47247810.1302/0301-620X.104B4.BJJ-2021-0167.R5
GauglerMKrahenbuhlNBargAEffect of age on outcome and revision in total ankle arthroplastyBone Joint J2020102B92593210.1302/0301-620X.102B7.BJJ-2019-1263.R2
PangrazziGJBakerEAShaheenPJSingle-surgeon experience and complications of a fixed-bearing total ankle arthroplastyFoot Ankle Int201839465810.1177/107110071773528829035609
BurnhamRRKiernanHOrtegaLFDefining the learning curve of anterior total hip arthroplasty after fellowship-specific trainingJ Am Acad Orthop Surg202230e131e13810.5435/JAAOS-D-21-0023234534151
SaltzmanCLAmendolaAAndersonRSurgeon training and complications in total ankle arthroplastyFoot Ankle Int20032451451810.1177/10711007030240061212854675
SyedFUgwuokeAAnkle arthroplasty: a review and summary of results from joint registries and recent studiesEfort Open Rev2018339139710.1302/2058-5241.3.170029300348206026887
HoerlesbergerNGlehrMAmerstorferFResidents’ learning curve of total knee arthroplasty based on radiological outcome parameters: a retrospective comparative studyJ Arthroplasty20213615415910.1016/j.arth.2020.07.04532839061
KingABaliNKassamAAEarly outcomes and radiographic alignment of the Infinity total ankle replacement with a minimum of two year follow-up dataFoot Ankle Surg20192582683310.1016/j.fas.2018.11.00730638815
Maccario C, Paoli T, Romano F, et al (2022) Transfibular total ankle arthroplasty : a new reliable procedure at five-year follow-up. Bone Joint J 104-B:472–478. https://doi.org/10.1302/0301-620X.104B4.BJJ-2021-0167.R5
MaccarioCTanEWDi SilvestriCALearning curve assessment for total ankle replacement using the transfibular approachFOOT ANKLE Surg20212712913710.1016/j.fas.2020.03.00532201087
VakhshoriVSabourAFAlluriRKPatient and practice trends in total ankle replacement and tibiotalar arthrodesis in the united states from 2007 to 2013J Am Acad Orthop Surg201927e77e8410.5435/JAAOS-D-17-0052630169446
MehtaNChamberlinPMarxRGDefining the learning curve for hip arthroscopy: a threshold analysis of the volume-outcomes relationshipAm J Sports Med2018461284129310.1177/036354651774921929337602
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5064_CR1
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Q Wang (5064_CR48) 2021; 45
B Stein (5064_CR53) 2022; 15
TR Daniels (5064_CR43) 2015; 97A
C Maccario (5064_CR20) 2021; 27
A Haskell (5064_CR30) 2004; 25
V Vakhshori (5064_CR2) 2019; 27
F Syed (5064_CR51) 2018; 3
5064_CR47
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AA Spirt (5064_CR40) 2004; 86A
5064_CR44
KB Lee (5064_CR34) 2008; 29
SE Johnson-Lynn (5064_CR45) 2018; 36
JM Schuberth (5064_CR39) 2006; 45
K Slim (5064_CR26) 2003
AN Fletcher (5064_CR11) 2021; 42
5064_CR16
WJ Choi (5064_CR12) 2014; 96B
GJ Pangrazzi (5064_CR37) 2018; 39
A Henricson (5064_CR31) 2007; 78
L Heisler (5064_CR49) 2022; 43
N Hoerlesberger (5064_CR19) 2021; 36
JL Hodgins (5064_CR18) 2014; 30
R Clement (5064_CR28) 2013; 6
A King (5064_CR32) 2019; 25
DJ Cunningham (5064_CR46) 2021; 103
M Tada (5064_CR14) 2022
RR Burnham (5064_CR17) 2022; 30
R Zaidi (5064_CR4) 2013; 95B
5064_CR24
5064_CR21
HY Yang (5064_CR7) 2019; 101B
M Ouzzani (5064_CR25) 2016
CE Gross (5064_CR41) 2016; 37
ST Bleazey (5064_CR27) 2013; 52
CL Saltzman (5064_CR38) 2003; 24
M Herrera-Pérez (5064_CR3) 2022; 7
MI Escudero (5064_CR50) 2021; 42
T Clough (5064_CR8) 2019; 101B
TR Daniels (5064_CR29) 2014; 96A
A Lampley (5064_CR13) 2016; 37
5064_CR6
FG Usuelli (5064_CR22) 2017; 23
FG Usuelli (5064_CR54) 2017; 22
KT Lee (5064_CR35) 2013; 34
L Dagneaux (5064_CR42) 2022; 104
References_xml – volume: 97A
  start-page: 904
  year: 2015
  ident: 5064_CR10
  publication-title: J BONE Jt SURGERY-AMERICAN
  doi: 10.2106/JBJS.N.00837
  contributor:
    fullname: M Bouchard
– ident: 5064_CR16
  doi: 10.1016/j.arthro.2013.11.012
– volume: 37
  start-page: 1052
  year: 2016
  ident: 5064_CR13
  publication-title: FOOT ANKLE Int
  doi: 10.1177/1071100716655435
  contributor:
    fullname: A Lampley
– volume: 78
  start-page: 569
  year: 2007
  ident: 5064_CR31
  publication-title: ACTA Orthop
  doi: 10.1080/17453670710014248
  contributor:
    fullname: A Henricson
– volume: 39
  start-page: 46
  year: 2018
  ident: 5064_CR37
  publication-title: Foot Ankle Int
  doi: 10.1177/1071100717735288
  contributor:
    fullname: GJ Pangrazzi
– volume: 101B
  start-page: 47
  year: 2019
  ident: 5064_CR8
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.101B1.BJJ-2018-0801.R1
  contributor:
    fullname: T Clough
– volume: 22
  start-page: 477
  year: 2017
  ident: 5064_CR54
  publication-title: Foot Ankle Clin
  doi: 10.1016/j.fcl.2017.01.010
  contributor:
    fullname: FG Usuelli
– volume: 101B
  start-page: 695
  year: 2019
  ident: 5064_CR7
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.101B6.BJJ-2018-1678.R1
  contributor:
    fullname: HY Yang
– volume: 104B
  start-page: 472
  year: 2022
  ident: 5064_CR5
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.104B4.BJJ-2021-0167.R5
  contributor:
    fullname: C Maccario
– volume: 81
  start-page: 114
  year: 2010
  ident: 5064_CR52
  publication-title: ACTA Orthop
  doi: 10.3109/17453671003685459
  contributor:
    fullname: ET Skytta
– volume: 27
  start-page: 129
  year: 2021
  ident: 5064_CR20
  publication-title: FOOT ANKLE Surg
  doi: 10.1016/j.fas.2020.03.005
  contributor:
    fullname: C Maccario
– volume: 45
  start-page: 139
  year: 2006
  ident: 5064_CR39
  publication-title: J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg
  doi: 10.1053/j.jfas.2006.02.013
  contributor:
    fullname: JM Schuberth
– volume: 86A
  start-page: 1172
  year: 2004
  ident: 5064_CR40
  publication-title: J Bone Jt Surgery-Am
  doi: 10.2106/00004623-200406000-00008
  contributor:
    fullname: AA Spirt
– year: 2003
  ident: 5064_CR26
  publication-title: ANZ J Surg
  doi: 10.1046/j.1445-2197.2003.02748.x
  contributor:
    fullname: K Slim
– year: 2016
  ident: 5064_CR25
  publication-title: Syst Rev
  doi: 10.1186/s13643-016-0384-4
  contributor:
    fullname: M Ouzzani
– volume: 43
  start-page: 741
  year: 2022
  ident: 5064_CR49
  publication-title: Foot Ankle Int
  doi: 10.1177/10711007221077100
  contributor:
    fullname: L Heisler
– volume: 3
  start-page: 391
  year: 2018
  ident: 5064_CR51
  publication-title: Efort Open Rev
  doi: 10.1302/2058-5241.3.170029
  contributor:
    fullname: F Syed
– volume: 96B
  start-page: 1674
  year: 2014
  ident: 5064_CR12
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.96B12.34364
  contributor:
    fullname: WJ Choi
– volume: 34
  start-page: 210
  year: 2013
  ident: 5064_CR35
  publication-title: Foot ANKLE Int
  doi: 10.1177/1071100712467430
  contributor:
    fullname: KT Lee
– ident: 5064_CR6
  doi: 10.1302/0301-620X.103B4.BJJ-2020-0758.R1
– volume: 23
  start-page: 76
  year: 2017
  ident: 5064_CR22
  publication-title: Foot Ankle Surg
  doi: 10.1016/j.fas.2016.02.007
  contributor:
    fullname: FG Usuelli
– ident: 5064_CR21
  doi: 10.1177/1071100713518187
– volume: 13
  start-page: 19
  year: 2007
  ident: 5064_CR33
  publication-title: Foot Ankle Surg
  doi: 10.1016/j.fas.2006.06.002
  contributor:
    fullname: A Kumar
– volume: 24
  start-page: 514
  year: 2003
  ident: 5064_CR38
  publication-title: Foot Ankle Int
  doi: 10.1177/107110070302400612
  contributor:
    fullname: CL Saltzman
– volume: 37
  start-page: 137
  year: 2016
  ident: 5064_CR41
  publication-title: Foot Ankle Int
  doi: 10.1177/1071100715606477
  contributor:
    fullname: CE Gross
– volume: 25
  start-page: 826
  year: 2019
  ident: 5064_CR32
  publication-title: Foot Ankle Surg
  doi: 10.1016/j.fas.2018.11.007
  contributor:
    fullname: A King
– volume: 45
  start-page: 2445
  year: 2021
  ident: 5064_CR48
  publication-title: Int Orthop
  doi: 10.1007/s00264-021-05145-8
  contributor:
    fullname: Q Wang
– volume: 104
  start-page: 684
  year: 2022
  ident: 5064_CR42
  publication-title: J Bone Jt Surg-Am
  doi: 10.2106/JBJS.21.00746
  contributor:
    fullname: L Dagneaux
– year: 2022
  ident: 5064_CR23
  publication-title: J Orthop Sci Off J Jpn Orthop Assoc
  doi: 10.1016/j.jos.2022.05.008
  contributor:
    fullname: H Kurokawa
– volume: 95B
  start-page: 1500
  year: 2013
  ident: 5064_CR4
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.95B11.31633
  contributor:
    fullname: R Zaidi
– volume: 36
  start-page: 154
  year: 2021
  ident: 5064_CR19
  publication-title: J Arthroplasty
  doi: 10.1016/j.arth.2020.07.045
  contributor:
    fullname: N Hoerlesberger
– volume: 102B
  start-page: 925
  year: 2020
  ident: 5064_CR9
  publication-title: Bone Joint J
  doi: 10.1302/0301-620X.102B7.BJJ-2019-1263.R2
  contributor:
    fullname: M Gaugler
– volume: 15
  start-page: 127
  year: 2022
  ident: 5064_CR53
  publication-title: Foot Ankle Spec
  doi: 10.1177/1938640020950156
  contributor:
    fullname: B Stein
– ident: 5064_CR1
  doi: 10.1177/19386400221110133
– volume: 46
  start-page: 1284
  year: 2018
  ident: 5064_CR15
  publication-title: Am J Sports Med
  doi: 10.1177/0363546517749219
  contributor:
    fullname: N Mehta
– volume: 6
  start-page: 263
  year: 2013
  ident: 5064_CR28
  publication-title: Foot Ankle Spec
  doi: 10.1177/1938640013493463
  contributor:
    fullname: R Clement
– ident: 5064_CR44
  doi: 10.1302/0301-620X.103B7.BJJ-2020-2058.R2
– volume: 27
  start-page: e77
  year: 2019
  ident: 5064_CR2
  publication-title: J Am Acad Orthop Surg
  doi: 10.5435/JAAOS-D-17-00526
  contributor:
    fullname: V Vakhshori
– year: 2022
  ident: 5064_CR14
  publication-title: Mod Rheumatol
  doi: 10.1093/mr/roac123
  contributor:
    fullname: M Tada
– ident: 5064_CR24
  doi: 10.1136/bmj.n160
– volume: 30
  start-page: 613
  year: 2014
  ident: 5064_CR18
  publication-title: Arthrosc J Arthrosc Relat Surg
  doi: 10.1016/j.arthro.2014.02.021
  contributor:
    fullname: JL Hodgins
– volume: 103
  start-page: 131
  year: 2021
  ident: 5064_CR46
  publication-title: J Bone Jt Surgery-Am
  doi: 10.2106/JBJS.20.00395
  contributor:
    fullname: DJ Cunningham
– volume: 36
  start-page: 1
  year: 2018
  ident: 5064_CR45
  publication-title: Foot (Edinb)
  doi: 10.1016/j.foot.2018.07.001
  contributor:
    fullname: SE Johnson-Lynn
– volume: 42
  start-page: 851
  year: 2021
  ident: 5064_CR50
  publication-title: Foot Ankle Int
  doi: 10.1177/1071100721996379
  contributor:
    fullname: MI Escudero
– volume: 96A
  start-page: 135
  year: 2014
  ident: 5064_CR29
  publication-title: J Bone Jt Surg-Am
  doi: 10.2106/JBJS.L.01597
  contributor:
    fullname: TR Daniels
– volume: 52
  start-page: 36
  year: 2013
  ident: 5064_CR27
  publication-title: J Foot Ankle Surg
  doi: 10.1053/j.jfas.2012.10.009
  contributor:
    fullname: ST Bleazey
– volume: 97A
  start-page: 895
  year: 2015
  ident: 5064_CR43
  publication-title: J Bone Jt Surg-Am
  doi: 10.2106/JBJS.N.01077
  contributor:
    fullname: TR Daniels
– volume: 42
  start-page: 776
  year: 2021
  ident: 5064_CR11
  publication-title: Foot Ankle Int
  doi: 10.1177/1071100720985292
  contributor:
    fullname: AN Fletcher
– volume: 29
  start-page: 978
  year: 2008
  ident: 5064_CR34
  publication-title: Foot Ankle Int
  doi: 10.3113/FAI.2008.0978
  contributor:
    fullname: KB Lee
– volume: 24
  start-page: 17
  year: 2003
  ident: 5064_CR36
  publication-title: Foot Ankle Int
  doi: 10.1177/107110070302400102
  contributor:
    fullname: MS Myerson
– ident: 5064_CR47
  doi: 10.1302/0301-620X.104B4.BJJ-2021-0167.R5
– volume: 7
  start-page: 448
  year: 2022
  ident: 5064_CR3
  publication-title: EFORT Open Rev
  doi: 10.1530/EOR-21-0117
  contributor:
    fullname: M Herrera-Pérez
– volume: 30
  start-page: e131
  year: 2022
  ident: 5064_CR17
  publication-title: J Am Acad Orthop Surg
  doi: 10.5435/JAAOS-D-21-00232
  contributor:
    fullname: RR Burnham
– volume: 25
  start-page: 283
  year: 2004
  ident: 5064_CR30
  publication-title: Foot Ankle Int
  doi: 10.1177/107110070402500502
  contributor:
    fullname: A Haskell
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Snippet Introduction Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of...
Together with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of the ankle....
IntroductionTogether with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of...
INTRODUCTIONTogether with ankle arthrodesis, total ankle arthroplasty is now accepted as a first-line intervention in the management of end-stage arthritis of...
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SubjectTerms Ankle
Joint surgery
Learning curves
Medicine
Medicine & Public Health
Orthopaedic Surgery
Orthopedics
Radiation
Systematic review
Title Learning curve of total ankle arthroplasty: a systematic review
URI https://link.springer.com/article/10.1007/s00402-023-05064-w
https://www.ncbi.nlm.nih.gov/pubmed/37917408
https://www.proquest.com/docview/2919207994
https://search.proquest.com/docview/2886326853
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