13-19 year results of a consecutive series of 200 Scandinavian Total Ankle Replacements (STAR): the Wrightington experience

T. Clough, C. Talbot, P. Siney, M. Karski

¹Wrightington Hospital, Wigan, United Kingdom

Introduction: The Scandinavian Total Ankle Replacement (STAR) is a three-component, uncemented implant in widespread use throughout Europe. STAR has achieved encouraging results with short and medium term outcome. We present the long term (13-19 year) results of a consecutive series of 200 STAR ankles.

Methods: Between November 1993 and February 2000, a total of 200 consecutive STARs were carried out in 184 patients. Patients were followed up both clinically and radiologically, until death or failure, with time to decision to revision or fusion as the endpoint. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score.

Results: Of the 200 STARs, 109 (105 patients) were alive at latest review. 12 STARs (11 patients) were lost to follow-up, leaving 97 ankles for clinical review. Of these, 76 ankles were surviving and 21 ankles had failed [13 underwent arthrodesis, 4 had an exchange of poly insert, and 4 had a revision TAR], with mean time to failure 82 months (2-156 months). For the 91 ankles in 79 patients who died during the study, 8 had failed [6 underwent revision TAR and 2 had an arthrodesis]. The implant survival at 15 years with endpoint of revision for any reason was 76.9% [95% CI 66.4 to 87.3]. The mean AOFAS score was 72 [20 to 96]. The mean annual failure rate was 1.5%, which was steady across the study period.

Conclusion: The 15 year survivorship for the STAR prosthesis was 76.9%, which provides a benchmark for other later design ankle prostheses. We found no drop off in failure rate or function over the study period.

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