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A STAR of Hope for Ankle Arthritis

Slowly but surely, ankle joint implants are making their way onto the market with better and better results. Whether you have rheumatoid arthritis, osteoarthritis, or arthritis after trauma, these implants can replace the damaged ankle joint.

Studies from around the world are helping reshape and redesign ankle implants. The tools used during the surgery to put the new joint in place are also improving. This study from Sweden reviews the results of 51 uncemented STAR (Scandinavian Total Ankle Replacement) implants.

The operations were all done between 1993 and 1999. Since that time the implants have improved. Doctors now use even better tools. Early results with the STAR weren't as good as implants just five years later.

The authors report that getting full ankle motion back isn't always easy. Ankles with good motion before the operation actually lose range after the operation. Getting full dorsiflexion (pulling toes toward the nose) is a common problem with the STAR.

The operation to replace the ankle takes a lot of skill and practice. In this review, technical failures resulted in the need to replace the original joint replacement. Sometimes just one part of the implant was replaced. In other cases the implant was removed and the ankle joint fused. These problems are getting worked out over time.

The authors conclude the ankle joint replacement has its place. Patients with rheumatoid arthritis seem to do the best and get enough motion to walk normally. Choosing the right-sized implant and putting it in correctly are important.

Even with an experienced surgeon and the right implant, failure is still possible. The risk of implant loosening and failure is much higher with ankle implants than with total hip or knee replacements. Researchers are working to change this and improve the outcome with STAR.

Thomas Anderson, MD, et al. Uncemented STAR Total Ankle Prostheses: Three- to Eight-Year Follow-Up of Fifty-One Consecutive Ankles. In The Journal of Bone and Joint Surgery. July 2003. Vol. 85-A. No. 7. Pp. 1321-1329.

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