Patients with Chronic Obstructive Pulmonary Disease Undergoing Total Ankle Arthroplasty Have Shorter Operative Time and Longer Hospital Length of Stay

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Kian Bagheri, DO: No financial relationships to discloseBackground and/or Objectives: COPD is associated with adverse outcomes after major joint arthroplasty, but its impact on total ankle arthroplasty (TAA) remains unclear.Understanding this relationship may inform perioperative risk stratification and rehabilitation planning.Design: Retrospective cohort study using a nationally representative surgical outcomes database. Setting: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2012-2020.Participants: 1,619 adults undergoing primary total ankle arthroplasty, including 42 patients with a documented history of severe COPD.Interventions: Primary total ankle arthroplasty.Main Outcome Measures: Operative time, hospital length of stay (LOS), and 30-day readmission following TAA.Results: After multivariable adjustment, COPD was independently associated with shorter operative time (β = À0.33,p=0.037) and longer hospital LOS (β = 0.37, p=0.039).COPD was not independently associated with 30-day readmission.Conclusions: Patients with COPD undergoing TAA experience prolonged hospitalization, suggesting increased rehabilitation and discharge planning needs.These findings highlight the importance of perioperative optimization and early PM&R involvement in this population.