title: The Scandinavian total ankle replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients.
abstract: BACKGROUND
  The objective of this study was to determine the long-term survivorship and clinical and radiographic results of the Scandinavian Total Ankle Replacement (STAR).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinic of Orthopaedic Surgery, Kantonsspital Liestal, Rheinstrasse 26, CH-4410 Liestal, Switzerland. alexejbarg@mail.ru
authors.forename: Samuel
authors.initials: S
authors.lastname: Brunner
authors.forename: Alexej
authors.initials: A
authors.lastname: Barg
authors.forename: Markus
authors.initials: M
authors.lastname: Knupp
authors.forename: Lukas
authors.initials: L
authors.lastname: Zwicky
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Kapron
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
authors.forename: Beat
authors.initials: B
authors.lastname: Hintermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects / Q000295:instrumentation*; D015331:Cohort Studies; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011474:Prosthesis Design / Q000009:adverse effects; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries; D013997:Time Factors; D055815:Young Adult