Decide for Yourself, Don't Let Biases Decide for You

Strict BMI cutoffs for total ankle arthroplasty (TAA) may unintentionally restrict who gets surgery. 

A recent study of 1,215 TAA patients from the ACS-NSQIP database (2011–2020) found that applying common BMI eligibility cutoffs (<50, <45, <40, <35) disproportionately affected certain racial, ethnic, sex, and age groups. 

What they found

The analysis revealed notable disparities in eligibility across these demographic groups:

• The tighter the BMI cutoff, the bigger the disparities.

• Black patients were significantly less likely to qualify at BMI <35.

• Hispanic patients had lower eligibility across all cutoffs.

• White non-Hispanic and Asian/Pacific Islander patients were more likely to meet BMI thresholds.

• Women were consistently less likely to qualify  than men.

• Younger patients were more often excluded than older ones.

Bottom line

Rigid BMI rules may unintentionally restrict access to TAA, especially for Black, Hispanic, female, and younger patients.