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[Total ankle joint replacement].

B Hintermann1, V Valderrabano

  • 1Orthopädische Universitätsklinik, Kantonsspital, Basel. bhintermann@datacomm.ch

Zeitschrift Fur Arztliche Fortbildung Und Qualitatssicherung
|June 12, 2001
PubMed
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This study on the S.T.A.R. total ankle prosthesis found that while most patients were satisfied with uncemented fixation, a high revision rate necessitates further long-term evaluation.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Biomechanics

Context:

  • The S.T.A.R. (total ankle replacement) prosthesis utilizes uncemented fixation for ankle replacements.
  • This study retrospectively evaluated 79 ankle replacements in 76 patients performed between 1996 and 2000.
  • Primary diagnoses included posttraumatic osteoarthrosis, primary osteoarthrosis, and systemic joint affections.

Purpose:

  • To evaluate the short- to mid-term clinical outcomes and implant stability of the S.T.A.R. total ankle prosthesis with uncemented fixation.
  • To assess patient satisfaction, range of motion, and functional scores (AOFAS-Hindfoot-Score).
  • To identify factors contributing to revision operations and overall prosthesis performance.

Summary:

  • The study reported high patient satisfaction (95%) and stable, well-fixed implants at mid-term follow-up, with a mean AOFAS-Hindfoot-Score of 84.

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  • Achieved range of motion was 35 degrees, with specific plantarflexion and dorsiflexion values noted.
  • Despite favorable functional outcomes, a significant revision rate (29 operations) was observed, attributed to component design and instrumentation issues.

    • Impact:

    • Total ankle replacement with the S.T.A.R. prosthesis is a viable alternative to ankle arthrodesis, offering good functional results.
    • The high revision rate highlights areas for improvement in prosthesis design and surgical technique.
    • Longer-term follow-up is crucial to determine the ultimate prognosis and durability of this uncemented total ankle prosthesis.