Obesity Not Associated With Worse Long-Term TAR Outcomes - Summary - MDSpire

Obesity Not Associated With Worse Long-Term TAR Outcomes

A long-term cohort study found that obesity was not associated with worse patient-reported outcomes or higher reoperation rates following total ankle replacement in optimized surgical candidates.

  • By

  • Kathryn Wighton

  • May 6, 2026

  • 4 min

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Objective:

To evaluate long-term outcomes of total ankle replacement (TAR) in patients with obesity compared to those without obesity, specifically focusing on pain, disability, and complication rates.

Key Findings:
  • Improvements in pain and disability scores were not significantly different between patients with obesity and those without, with AOS pain improvement at 48.7% for obesity vs 45.2% for non-obesity.
  • Patients with obesity showed greater absolute functional gains despite starting with worse preoperative disability scores.
  • Reoperation and complication rates were similar between both groups, with major complications occurring in approximately 17% of cases.
Interpretation:

Obesity may not be a contraindication for total ankle replacement in appropriately selected patients, suggesting that outcomes can be comparable to those without obesity, which has important implications for clinical practice.

Limitations:
  • Retrospective design limits causal inference.
  • Results may not generalize to lower-volume settings or to patients with more severe obesity, as the study did not stratify outcomes by obesity class.
  • Selection bias may exist as healthier patients with obesity might have been preferentially selected.
Conclusion:

The study supports the use of total ankle replacement in selected obese patients, challenging the perception of obesity as a relative contraindication.

Original Source(s)

Obesity Not Associated With Worse Long-Term TAR Outcomes

  • by Kathryn Wighton

  • May 6, 2026

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