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Revision of the Failed STAR Total Ankle Replacement

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Primary and Revision Total Ankle Replacement

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Abstract

The Scandinavian Total Ankle Replacement (STAR) is one of the most commonly implanted total ankle replacements globally. The STAR has been in clinical use in Europe since 1981 and in the United States since 2009. Clinical outcomes following total ankle replacement with the STAR prosthesis are good to excellent, but implant survivorship averages around 71 % at 10 years postoperatively. Implant failure is most commonly due to aseptic loosening, malalignment, deep infection, and polyethylene bearing fracture. Failure of the STAR prosthesis can be implementation related or design related. Poor bone quality, bone loss, ligamentous laxity, non-correctable deformity, and infection can all potentially compromise the outcome following total ankle replacement. The procedure has a high learning curve, and some characteristics of STAR prosthesis implantation may be especially challenging in the hands of an inexperienced surgeon. Various aspects of the STAR design may contribute to overloading and fracture of the polyethylene bearing. The relationship between the tibial surface and the polyethylene insert is unable to accommodate coronal plane motion, resulting in edge loading. The fixed curvature of the talar component may also lead to a mild ligament imbalance and edge loading.

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References

  1. Brunner S, Barg A, Knupp M, Zwicky L, Kapron AL, Valderrabano V, et al. The Scandinavian total ankle replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients. J Bone Joint Surg Am. 2013;95(8):711–8.

    Article  PubMed  Google Scholar 

  2. Kofoed H. Scandinavian total ankle replacement (STAR). Clin Orthop Relat Res. 2004;424:73–9.

    Article  Google Scholar 

  3. Crock HV. The bones of the foot. In: Crock HV, editor. The blood supply of the lower limb bones in man. Edinburgh: E & S Livingstone; 1967. p. 72–9.

    Google Scholar 

  4. Buechel Sr FF, Buechel Jr FF, Pappas MJ. Ten-year evaluation of cementless Buechel-Pappas meniscal bearing total ankle replacement. Foot Ankle Int. 2003;24(6):462–72.

    Article  PubMed  Google Scholar 

  5. Kofoed H, Sorensen TS. Ankle arthroplasty for rheumatoid arthritis and osteoarthritis: prospective long-term study of cemented replacements. J Bone Joint Surg Br. 1998;80(2):328–32.

    Article  CAS  PubMed  Google Scholar 

  6. Kofoed H. Cylindrical cemented ankle arthroplasty: a prospective series with long-term follow-up. Foot Ankle Int. 1995;16(8):474–9.

    Article  CAS  PubMed  Google Scholar 

  7. Kofoed H, Lundberg-Jensen A. Ankle arthroplasty in patients younger and older than 50 years: a prospective series with long-term follow-up. Foot Ankle Int. 1999;20(8):501–6.

    Article  CAS  PubMed  Google Scholar 

  8. Wood PL, Deakin S. Total ankle replacement. The results in 200 ankles. J Bone Joint Surg Br. 2003;85(3):334–41.

    Article  CAS  PubMed  Google Scholar 

  9. Wood PL, Prem H, Sutton C. Total ankle replacement: medium-term results in 200 Scandinavian total ankle replacements. J Bone Joint Surg Br. 2008;90(5):605–9.

    Article  CAS  PubMed  Google Scholar 

  10. Karantana A, Hobson S, Dhar S. The scandinavian total ankle replacement: survivorship at 5 and 8 years comparable to other series. Clin Orthop Relat Res. 2010;468(4):951–7.

    Article  PubMed  Google Scholar 

  11. Zhao H, Yang Y, Yu G, Zhou J. A systematic review of outcome and failure rate of Scandinavian total ankle replacement. Int Orthop. 2011;35(12):1751–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Prissel MA, Roukis TS. Incidence of revision after primary implantation of the Scandinavian Total Ankle Replacement system: a systematic review. Clin Podiatr Med Surg. 2013;30(2):237–50.

    Article  PubMed  Google Scholar 

  13. Anderson T, Montgomery F, Carlsson A. Uncemented STAR total ankle prostheses. Three to eight-year follow-up of fifty-one consecutive ankles. J Bone Joint Surg Am. 2003;85A(7):1321–9.

    Article  Google Scholar 

  14. Mann JA, Mann RA, Horton E. STAR ankle: long-term results. Foot Ankle Int. 2011;32(5):S473–84.

    Article  PubMed  Google Scholar 

  15. Nunley JA, Caputo AM, Easley ME, Cook C. Intermediate to long-term outcomes of the STAR Total Ankle Replacement: the patient perspective. J Bone Joint Surg Am. 2012;94(1):43–8.

    Article  PubMed  Google Scholar 

  16. Jastifer JR, Coughlin MJ. Long-term follow-up of mobile bearing total ankle arthroplasty in the United States. Foot Ankle Int. 2015;36(2):143–50.

    Article  PubMed  Google Scholar 

  17. Daniels TR, Mayich JD, Penner MJ. Intermediate to long-term outcomes of total ankle replacement with the Scandinavian Total Ankle Replacement (STAR). J Bone Joint Surg Am. 2015;97(11):895–903.

    Article  PubMed  Google Scholar 

  18. Saltzman CL, Mann RA, Ahrens JE, Amendola A, Anderson RB, Berlet GC, et al. Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int. 2009;30(7):579–96.

    Article  PubMed  Google Scholar 

  19. Wood PL, Sutton C, Mishra V, Suneja R. A randomised, controlled trial of two mobile-bearing total ankle replacements. J Bone Joint Surg Br. 2009;91(1):69–74.

    Article  CAS  PubMed  Google Scholar 

  20. Penner MJ, Laflamme M. The Scandinavian Total Ankle Replacement prosthesis: design and implementation pitfalls resulting in revision surgery. In: Haddad SL, editor. Total ankle arthroplasty. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2015. p. 71–87.

    Google Scholar 

  21. Laflamme M, Penner MJ, Mayich J, Daniels TR. Catastrophic polyethylene failure in the Scandinavian Total Ankle Replacement (STAR): an analysis of patient and implant-related factors. Am Orthop Foot Ankle Soc Annu Meeting Proc. 2012;2012:35–6.

    Google Scholar 

  22. Haskell A, Mann RA. Perioperative complication rate of total ankle replacement is reduced by surgeon experience. Foot Ankle Int. 2004;25(5):283–9.

    Article  PubMed  Google Scholar 

  23. Henricson A, Skoog A, Carlsson A. The Swedish Ankle Arthroplasty Register: an analysis of 531 arthroplasties between 1993 and 2005. Acta Orthop. 2007;78(5):569–74.

    Article  PubMed  Google Scholar 

  24. Easley ME, Adams Jr SB, Hembree WC, DeOrio JK. Results of total ankle arthroplasty. J Bone Joint Surg Am. 2011;93(15):1455–68.

    Article  PubMed  Google Scholar 

  25. Schimmel JJ, Walschot LH, Louwerens JW. Comparison of the short-term results of the first and last 50 scandinavian total ankle replacements: assessment of the learning curve in a consecutive series. Foot Ankle Int. 2014;35(4):326–33.

    Article  PubMed  Google Scholar 

  26. Hintermann B, Valderrabano V. Total ankle replacement. Foot Ankle Clin. 2003;8(2):375–405.

    Article  PubMed  Google Scholar 

  27. Koivu H, Mackiewicz Z, Takakubo Y, Trokovic N, Pajarinen J, Konttinen YT. RANKL in the osteolysis of AES total ankle replacement implants. Bone. 2012;51(3):546–52.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, St. Michael’s Hospital, University of Toronto, 800—55 Queen Street East, Toronto, ON, Canada, M5C 1R6

    Timothy R. Daniels MD, FRCSC & Sagar J. Desai MD, MSc, FRCSC

  2. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Murray J. Penner MD, BMechEng, FRCSC

  3. Department of Orthopaedics, St. Paul’s Hospital, Vancouver Coastal Health Authority and Providence Health Care, 1000-1200 Burrard Street, Vancouver, BC, Canada, V6Z 2C7

    Murray J. Penner MD, BMechEng, FRCSC

Authors
  1. Timothy R. Daniels MD, FRCSC
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  2. Sagar J. Desai MD, MSc, FRCSC
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  3. Murray J. Penner MD, BMechEng, FRCSC
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Corresponding author

Correspondence to Timothy R. Daniels MD, FRCSC .

Editor information

Editors and Affiliations

  1. Gundersen Health System, La Crosse, Wisconsin, USA

    Thomas S. Roukis

  2. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Gregory C. Berlet

  3. Wisconsin Foot and Ankle Institute, Marshfield, Wisconsin, USA

    Christopher Bibbo

  4. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Christopher F. Hyer

  5. Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada

    Murray J. Penner

  6. Foot and Ankle Center Karlsruhe, Karlsruhe, Germany

    Markus Wünschel

  7. Atlantic Foot & Ankle Center of Chesapeake, Chesapeake, Virginia, USA

    Mark A. Prissel

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© 2016 Springer International Publishing Switzerland

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Daniels, T.R., Desai, S.J., Penner, M.J. (2016). Revision of the Failed STAR Total Ankle Replacement. In: Roukis, T., et al. Primary and Revision Total Ankle Replacement. Springer, Cham. https://doi.org/10.1007/978-3-319-24415-0_32

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  • DOI: https://doi.org/10.1007/978-3-319-24415-0_32

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24413-6

  • Online ISBN: 978-3-319-24415-0

  • eBook Packages: MedicineMedicine (R0)

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