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Survival of the Scandinavian total ankle replacement (STAR): results of ten to nineteen years follow-up

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Abstract

Purpose

The purpose of this study was to evaluate survival and clinical outcome of the Scandinavian total ankle replacement (STAR) prosthesis after a minimum of ten years up to a maximum of 19 years.

Methods

Fifty STAR prostheses in 46 patients with end stage ankle osteoarthritis operated between 1996 and 2006 by the same surgeon (MH) were included. Minimal follow-up was ten years (median 14.6 years, 95% confidence interval [CI] 12.9-16.4). Clinical (Kofoed score) and radiological assessments were taken before the operation and at one, ten (+2), and 16 (±3) years after implantation. The primary endpoint was defined as exchange of the whole prosthesis or conversion to arthrodesis (def. 1), exchange of at least one metallic component (def. 2), or exchange of any component including the inlay (due to breakage or wear) (def. 3). Survival was estimated according to Kaplan-Meier. Further reoperations related to STAR were also recorded.

Results

The ten year survival rate was (def. 1) 94% (CI 82-98%), (def. 2) 90% (CI, 77-96%), and (def. 3) 78% (CI 64-87%). The 19-year survival rate was (def. 1) 91% (CI 78-97%), (def. 2) 75% (CI 53-88%), and (def. 3) 55% (CI 34-71%). Considering any re-operations related to STAR, 52% (26/50) of prostheses were affected by re-operations. Mean pre-operative Kofoed score was 49, which improved to 84 after one year (n = 50), to 90 after ten years (n = 46), and to 89 after 16 years (n = 28).

Conclusions

The survival rate for def. 1 and 2 was high. However, re-operations occurred in 52% of all STAR prosthesis.

Study design

Retrospective cohort study, evidence Level 4.

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Author notes

  1. Frigg Arno and Germann Ursula contributed equally to this work.

Authors and Affiliations

  1. Orthopedic Department, University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland

    Arno Frigg, Ursula Germann & Monika Horisberger

  2. Foot and Ankle Surgery Zürich, Bahnhofstrasse 56, 8001, Zürich, Switzerland

    Arno Frigg

  3. Foot and Ankle Surgery Bern, Schänzlistrasse 33, 3013, Bern, Switzerland

    Ursula Germann & Martin Huber

Authors
  1. Arno Frigg
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  2. Ursula Germann
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  3. Martin Huber
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  4. Monika Horisberger
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Corresponding author

Correspondence to Arno Frigg.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

Stryker covered the costs for ethical approval and the statistical analysis, which was carried out in the clinical trial centre of the author’s university.

Ethical approval

The study was approved by the ethical review board. This study was carried out in accordance with the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

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Frigg, A., Germann, U., Huber, M. et al. Survival of the Scandinavian total ankle replacement (STAR): results of ten to nineteen years follow-up. International Orthopaedics (SICOT) 41, 2075–2082 (2017). https://doi.org/10.1007/s00264-017-3583-2

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  • DOI: https://doi.org/10.1007/s00264-017-3583-2

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