Obesity and total ankle arthroplasty: Contraindication or consideration

Table 4 Functional outcomes in obese and non-obese patients undergoing total ankle arthroplasty

Ref.	Functional measure	Preoperative		Statistical significance of difference (P value)	Postoperative		Main finding	Statistical significance of difference (P value)
		Obese	Non-obese		Obese	Non-obese
Gross et al[20], 2016	SMFA function	88.0 ± 17.4	81.9 ± 18.2	0.002	61.7 ± 19.9	54.9 ± 20.0	Obese patients had lower absolute functional scores compared with non-obese patients at final follow-up	0.009
	FADI	61.2 ± 7.7	54.5 ± 14.1	0.014	24.5 ± 17.3	16.2 ± 15.7		0.003
	FAOS pain	42.0 ± 18.4	46.3 ± 17.2	0.795	77.6 ± 18.5	84.8 ± 17.3		0.038
	SF-36 total	44.7 ± 17.5	49.5 ± 17.9	0.03	63.6 ± 20.3	73.7 ± 20.8		< 0.001
Kim et al[6], 2023	FADI, mean	58.17 ± 8.35	52.62 ± 14.32	0.008	21.65 ± 16.26	17.71 ± 16.61	Obese patients reported worse preoperative and postoperative PROMs overall	0.041
	SMFA, mean	37.92 ±13.13	33.18 ± 13.60	0.001	20.13 ± 13.69	15.36 ± 14.12		< 0.001
	SF-36, mean	47.10 ± 16.37	52.93 ± 18.07	0.002	64.78 ± 19.96	73.44 ± 19.92		< 0.001
	AOFAS hindfoot, mean	39.38 ± 15.73	42.33 ± 17.15	0.213	73.94 ± 15.8	77.74 ± 15.38		0.039
	FAOS pain, mean	35.70 ± 16.98	46.85 ± 18.42	< 0.001	76.28 ± 19.88	81.84 ± 18.85		0.006
Bouchard et al[21], 2015	AOS pain	55.88 ± 18.00	52.92 ± 19.41	0.47	19.59 ± 18.50	19.00 ± 16.80	Ankle arthroplasty significantly and similarly improved pain and disability scores in both obese and non-obese groups	0.93
	AOS disability	68.64 ± 14.09	59.79 ± 19.57	NS	28.21 ± 21.51	27.20 ± 19.33		0.82
	SF-36-PCS	29.54 ± 6.92	34.48 ± 9.05	0.01	39.21 ± 10.30	40.30 ± 9.84		0.62
	SF-36-MCS	50.86 ± 12.72	53.70 ± 11.24	0.32	50.51 ± 13.37	54.05 ± 9.27		0.30

Values of outcomes are reported as mean ± SD according to the original study. FADI: Foot and Ankle Disability Index; FAOS: Foot and Ankle Outcome Score; SF-36: 36-Item Short Form Health Survey; SMFA: Short Musculoskeletal Function Assessment; AOFAS: American Orthopaedic Foot and Ankle Society score; AOS: Ankle Osteoarthritis Scale; SF-36-PCS: 36-Item Short Form Health Survey Physical Component Summary; SF-36-MCS: 36-Item Short Form Health Survey Mental Component Summary; NS: Non-significant.