title: Long-term follow-up of mobile bearing total ankle arthroplasty in the United States.
abstract: BACKGROUND
  The published long-term follow-up of modern total ankle arthroplasty is limited. We report results after a minimum of 10-year follow-up in a cohort of patients who underwent the Scandinavian Total Ankle Replacement (STAR™) in the United States.
  
  
  METHODS
  Between 1998 and 2003, 18 patients underwent total ankle arthroplasty for end-stage ankle degeneration and were available for follow-up at a minimum of 10 years postoperatively out of a consecutive series of 41 patients. All surgeries were performed by a single surgeon at a single institution. Clinical, radiographic, and functional examinations were performed. Revision was defined as failure of either the tibial or the talar metallic component. The mean length of follow-up was 12.6 years (range, 10.2 to 14.6).
  
  
  RESULTS
  Overall implant survival was 94.4% (17/18). A total of 39% (7/18) required additional surgical procedures, most of which were performed greater than 9 years postoperatively, and 1 required a revision of the prosthesis. Preoperative VAS pain scale scores improved from 8.1 to 2.1 out of 10 at latest follow-up. Mean Buechel-Pappas Scale scores improved from 32.8 to 82.1 and mean AOFAS Ankle-Hindfoot Scale scores improved from 32.8 to 78.1 at latest follow-up. All patients reported their outcome as good or excellent.
  
  
  CONCLUSIONS
  In the current cohort of STAR ankle patients, implant survival, patient satisfaction, pain relief, and function were high. However, the rate of additional procedures was also high, which highlights the need for patient follow-up and additional long-term outcome studies on total ankle arthroplasty.
  
  
  METHODS
  Level IV, cohort study.
authors.affiliation: Borgess Orthopedics, Kalamazoo, MI, USA jrjast@gmail.com.
authors.forename: James R
authors.initials: JR
authors.lastname: Jastifer
authors.affiliation: Saint Alphonsus Coughlin Foot & Ankle Clinic, Boise, ID, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Coughlin
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000502:physiology*; D058737:Arthroplasty, Replacement, Ankle / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D014481:United States; D016474:Weight-Bearing
keywords: ankle arthritis; ankle replacement; long-term results; total ankle arthroplasty