Abstract
Worldwide, total ankle replacement is being offered more often as an alternative to ankle fusion. Most reports in the literature come from single centers with surgery performed by ‘high volume’ foot and ankle surgeons. We describe the New Zealand experience with the Scandinavian Total Ankle Replacement (STAR).
Ethical approval was gained for the study. Using the national joint register we identified all STARs performed in New Zealand. Patients were contacted by mail and consented to participate in the study. We retrospectively reviewed patient notes and x-rays. Patients were asked to complete and return an Oxford Ankle Score, WOMAC score, and SF-12.
Fifty two STARs were implanted in 49 patients between 1998 and 2005. Eleven surgeons performed between one and 13 operations. Forty one STARs in 39 patients were available for follow-up at an average of 58 months. Eight STARs had been revised (19.5%) at an average of 22 months post surgery. In patients with the implant still in-situ the average oxford score was 24.9, WOMACs core 17.3, SF-12 physical component 44.1, and SF-12 mental component 54. X-rays were available for review in 30 ankles. Most components were implanted in a good position. Intra-operative malleolar fracture was noted in six ankles. The tibial component was undersized in 5 patients and the talar component was oversized in three patients. Two cases of talar subsidence and 3 cases of tibial subsidence (one requiring revision) were noted on follow-up x-rays.
In New Zealand, the Scandinavian Total Ankle Replacement has a high revision rate at five years’ post surgery. A significant number of intra-operative malleolar fractures and component mal-sizing was noted. Patients who have not required revision mostly report acceptable ankle specific, and quality of life outcomes.
Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.
