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Related Experiment Videos

Uncemented STAR total ankle prostheses.

Thomas Anderson1, Fredrik Montgomery, Ake Carlsson

  • 1Department of Orthopaedics, Malmö University Hospital, Malmö SE-205 02, Sweden.

The Journal of Bone and Joint Surgery. American Volume
|October 7, 2004
PubMed
Summary

Total ankle replacement with the Scandinavian Total Ankle Replacement (STAR) prosthesis shows promising intermediate-term results, but risks of loosening and failure remain higher than in hip or knee replacements.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials engineering
  • Medical device design

Background:

  • Ankle joint replacement feasibility has been long-discussed.
  • Modern uncemented ankle prostheses dominate the market.
  • Clinical data on uncemented total ankle replacements is limited.

Purpose of the Study:

  • To review the intermediate-term clinical outcomes of the Scandinavian Total Ankle Replacement (STAR) prosthesis.
  • To assess complications, failures, patient satisfaction, and functional outcomes.
  • To evaluate the survival rate of the STAR prosthesis.

Main Methods:

  • Fifty-one consecutive uncemented, hydroxyapatite-coated STAR total ankle prostheses were implanted between 1993 and 1999.
  • Clinical examinations and standardized radiographs were performed by an independent surgeon.
  • Complications, failures, patient satisfaction, and functional scores (Kofoed, Mazur, AOFAS) were recorded for unrevised implants.

Main Results:

  • Twelve ankles required revision (7 for loosening, 2 for meniscal fracture, 3 for other reasons).
  • Eight additional ankles showed radiographic signs of loosening.
  • For 39 unrevised ankles (median follow-up 52 months), patient satisfaction was reported in 31 cases, with significant improvement in functional scores.

Conclusions:

  • Total ankle replacement with the STAR prosthesis is a viable alternative to arthrodesis when components are accurately positioned and sized.
  • However, the risks of component loosening and implant failure are higher compared to total hip or knee replacement.
  • Improved surgical technique and component selection may mitigate risks and enhance long-term outcomes.

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