Frühergebnisse nach Implantation der STAR-Sprunggelenkprothese

Krankenhaus Unfallchirurgie Leonberg Deutschland
Der Orthopäde (Impact Factor: 0.36). 08/2008; 37(8):783-787. DOI: 10.1007/s00132-008-1311-8


HintergrundIn einer retrospektiven Studie wurden die klinischen und radiologischen Ergebnisse nach Implantation einer STAR-Sprunggelenkprothese

Material und Methoden49Patienten mit einem Durchschnittsalter von 62,5Jahren wurden zwischen Januar 2000 und September 2004 mit einer Sprunggelenkprothese
vom Typ STAR versorgt. Nach durchschnittlich 30,4Monaten wurden 48Patienten klinisch und radiologisch nachuntersucht und
der Kofoed-Ankle-Score sowie die subjektive Zufriedenheit ermittelt.

ErgebnisseDer Kofoed-Ankle-Score konnte durch die Operation signifikant von 28 auf 86Punkte verbessert werden. 90% der Patienten waren
mit dem Operationsergebnis subjektiv zufrieden. Die Revisionsrate betrug 10%.

SchlussfolgerungDie Frühergebnisse nach Implantation einer STAR-Sprunggelenkprothese sind ermutigend. Bei korrekter Indikationsstellung kann
mit großer Wahrscheinlichkeit eine deutliche Schmerzreduktion und eine hohe Patientenzufriedenheit erzielt werden. Ob sich
die OSG-Prothesen im langfristigen Verlauf bewähren, bleibt abzuwarten.

BackgroundThis retrospective study was performed to investigate the clinical and radiological results after STAR total ankle replacement.

Material and methodsBetween January 2000 and September 2004, 49 patients with an average age of 62.5 years underwent total ankle replacement with
the STAR prosthesis. At an average follow-up of 30.4 months, 48 patients were examined clinically and radiologically. The
Kofoed ankle score and the patients’ subjective satisfaction were evaluated.

ResultsThe operation improved the Kofoed ankle score significantly, from 28 to 86 points, 90% of the patients were satisfied with
the results. The revision rate was 10%.

ConclusionThe early results after implantation of the STAR ankle prosthesis are encouraging. With correct indication, a high rate of
pain reduction and patient satisfaction can be achieved. The long-term benefit of this procedure has yet to be determined.

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    ABSTRACT: The purpose of this study was to provide cumulative data about the intermediate to long-term outcome of Scandinavian total ankle replacement (STAR) in the literature and to provide a summary of survival rate, implant failure rate and reasons. A comprehensive search for all relevant articles published in English and German from January 1995 to May 2011 was conducted. Two reviewers evaluated each study to determine whether it was eligible for inclusion and, if so, collected data of interest. The intermediate to long-term outcomes were determined. Evidence-based meta-analytic pooling of results across studies was performed to determine survival and failure rates. Sixteen primary studies with 2,088 implants were identified. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 77.8 points, and the mean Kofoed ankle score was 76.4 points. The pooled mean five year survival rate was 85.9% [95% confidence interval (CI) 80.9-90.3], and the pooled mean ten year survival rate was 71.1% (95% CI 60.9-81.5). Pooled failure rate was 11.1% (95% CI 7.6 -14.9), with a mean follow-up time of 52 months; 41% failed within one year of initial operation. The first three reasons associated with implant failure were aseptic loosening (5.2%), malalignment (1.7%) and deep infection (1.0%). We found that STAR prosthesis achieved encouraging results in terms of intermediate to long-term outcome. The five and ten year survival rates were acceptable. However, the failure rate was still high. The major reasons for implant failure were aseptic loosening and malalignment. Maybe the increase of surgeons' experience and patient selection could improve outcomes and decrease failure rate.
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    ABSTRACT: The objective of this study was to determine the long-term survivorship and clinical and radiographic results of the Scandinavian Total Ankle Replacement (STAR). From February 1996 to March 2000, seventy-seven ankles in seventy-two patients (thirty-seven female and thirty-five male patients, with an average age of fifty-six years) underwent total ankle replacement using the STAR prosthesis with a single coating of hydroxyapatite. Two patients were lost to follow-up, and twelve patients with thirteen ankle replacements died. The average duration of follow-up for the patients without revision was 12.4 years (range, 10.8 to 14.9 years). Sixty-two of the seventy-seven ankles were available for final follow-up. Twenty-nine (38%) of the seventy-seven ankles had a revision of at least one of the metallic components. The probability of implant survival was 70.7% at ten years and 45.6% at fourteen years. The main reasons for revision were aseptic loosening, subsidence of the talar component, and progressive cyst formation. Polyethylene insert fractures were observed in eleven ankles. While the midterm to short-term results for patients managed with the STAR prosthesis have been encouraging at 3.7 years, the long-term survivorship of the same cohort was considerably inferior. The subjective and clinical results of the patients with retained prostheses are generally good and comparable with results reported in the current literature. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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