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Related Concept Videos

Ankle Joint01:10

Ankle Joint

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Ankle prostheses. Mid-term results after Thompson-Richards and STAR prostheses.

S Schill1, C Biehl1, H Thabe1

  • 1Orthopädische und Rheumaorthopädische Abteilung, Kreuznacher Diakonie, Bad Kreuznach, Germany.

Der Orthopade
|March 2, 2017
PubMed
Summary

Cementless S. T. A. R. ankle prostheses demonstrated superior long-term outcomes compared to cemented Thompson-Richards prostheses, with higher survival rates and fewer complications in rheumatoid arthritis patients.

Keywords:
Key words Ankle arthroplastyRheumatoid arthritis

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Rheumatology

Background:

  • Rheumatoid arthritis frequently affects the ankle joint, necessitating surgical intervention.
  • Ankle replacement surgery aims to alleviate pain and restore function in patients with severe ankle arthritis.
  • Both cemented Thompson-Richards prostheses (TRP) and cementless S. T. A. R. prostheses are utilized for ankle arthroplasty.

Purpose of the Study:

  • To compare the clinical and radiological outcomes of cemented Thompson-Richards prostheses and cementless S. T. A. R. prostheses in patients with rheumatoid arthritis.
  • To evaluate the long-term survival rates and complication profiles of both prosthesis types.

Main Methods:

  • A retrospective study followed 37 patients (37 ankles) with rheumatoid arthritis who underwent ankle arthroplasty.
  • Twenty patients received cemented Thompson-Richards prostheses, and 19 received cementless S. T. A. R. prostheses.
  • Patient outcomes were assessed using the Kofoed ankle score, radiological examination, and revision rates over a 1-12 year follow-up period.

Main Results:

  • The S. T. A. R. group showed a higher mean Kofoed ankle score (86.9 pts) compared to the TRP group (77.7 pts) at follow-up.
  • Cemented TRP exhibited a high rate of tibial component radiolucency (53.3%) and three cases of talar subsidence.
  • Cementless S. T. A. R. prostheses had minimal radiolucency and no talar subsidence, with a 6-year estimated survival rate of 94.3% versus 87% at 12 years for TRP.

Conclusions:

  • Cementless S. T. A. R. prostheses appear to offer better clinical and radiological results than cemented Thompson-Richards prostheses in rheumatoid arthritis patients.
  • The S. T. A. R. prosthesis demonstrated a lower incidence of radiolucency and subsidence, contributing to a higher survival rate.
  • Further long-term studies are warranted to confirm these findings and optimize ankle arthroplasty techniques.