--- title: "Scandinavian Total Ankle Replacement: 15-year follow-up. | Sutter Health" description: "Small cohort showed STAR ankles with retention at 9 yrs were highly likely to survive to 15 yrs, contd to have signif pain improvemt, min decrease in function." url: "https://www.sutterhealth.org/research/publications/scandinavian-total-ankle-replacement-15-year-follow-up-1055312490" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Scandinavian Total Ankle Replacement: 15-year follow-up. # Scandinavian Total Ankle Replacement: 15-year follow-up. Palanca A, Mann RA, Mann JA, & Haskell A. _Foot Ankle Int. 39(2):135-142. doi: 10.1177/1071100717738747._ 2018-02-01 ## Abstract BACKGROUND: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandinavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. METHODS: Eighty-four TAAs were performed between 1998 and 2000. Metal component survivorship at 15 years was calculated with a Kaplan-Meier curve. Twenty-four (29%) of 84 patients were available for participation with a minimum 15-year follow-up. Any radiographic changes were documented. All additional procedures and complications were recorded. Clinical findings, self-reported performance and pain evaluations, and AOFAS ankle/hindfoot scores were noted. RESULTS: Metal implant survival was 73% at 15 years. Of the 24 patients available for clinical evaluation, 18 of 24 patients (70.7%) had no change in prosthetic alignment from the immediate postoperative radiograph. Only 1 subtalar fusion was required for symptomatic adjacent joint arthritis. Three patients sustained a broken polyethylene component. AOFAS scores improved from an average of 39.6 points preoperatively, to an average of 71.6. More than half (52.4%) of patients with retained implants required an additional surgical procedure; 3 required 2 additional procedures. The average time to subsequent procedure was 10.2 years. CONCLUSION: Our small cohort demonstrated STAR ankles with retention at 9 years were highly likely to survive to 15 years, and patients continued to have significant improvement in pain relief and minimal decrease in function. At 15 years from TAA, metal survivorship was 73%. As with all ankle replacements, supplementary procedures were common. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29389250) ![Andrew Haskell, M.D.](https://dyn.mktgcdn.com/p/e19Z0QwiEJVIawTe_Uey_VlyYexupaSsdn87lO6XoJk/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Andrew Haskell, M.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/andrew-haskell-md-1049681101) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Percutaneous plating of Weber B fibular fractures.](https://www.sutterhealth.org/research/publications/percutaneous-plate-weber-b-fibula-fx-1055312373) Saxena A, Yun A. J Foot Ankle Surg. pii: S1067-2516(16)30393-3. doi: 10.1053/j.jfas.2016.11.012. \[Epub ahead of print\] 2017 Jan 12 - Publication ### [The "not so simple" ankle fracture: avoiding problems and pitfalls to improve patient outcomes.](https://www.sutterhealth.org/research/publications/complex-ankle-fx-pt-outcomes-1055312981) Hak DJ, Egol KA, Gardner MJ, Haskell A. Instr Course Lect. 60:73-88. 2011 Jan 01 - Publication ### [Osteotome technique for removal of symptomatic ear canal exostoses.](https://www.sutterhealth.org/research/publications/osteotome-technique-remove-ear-canal-exostoses-1055312952) Hetzler DG. Laryngoscope. 117(1 Pt 2 suppl 113):1-14. 2007 Jan 01 - Publication ### [Association of short-term complications with procedures through separate incisions during total ankle replacement.](https://www.sutterhealth.org/research/publications/short-term-complications-sep-incisions-tar-1055312445) Criswell B, Hunt K, Kim T, Chou L, Haskell A. Foot Ankle Int. pii: 1071100716651964. \[Epub ahead of print\] 2016 Jun 08 - Publication ### [Lapidus arthrodesis.](https://www.sutterhealth.org/research/publications/lapidus-arthrodesis-1055312388) Hyer CF, Saxena A, Didomenico L. J Foot Ankle Surg. 50(6):784-5; author reply 785. doi: 10.1053/j.jfas.2011.09.014. 2011 Nov 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/scandinavian-total-ankle-replacement-15-year-follow-up-1055312490#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Scandinavian Total Ankle Replacement: 15-year follow-up."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/scandinavian-total-ankle-replacement-15-year-follow-up-1055312490#medicalscholarlyarticle","name":"Scandinavian Total Ankle Replacement: 15-year follow-up.","headline":"Scandinavian Total Ankle Replacement: 15-year follow-up.","abstract":"BACKGROUND: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandinavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. METHODS: Eighty-four TAAs were performed between 1998 and 2000. Metal component survivorship at 15 years was calculated with a Kaplan-Meier curve. Twenty-four (29%) of 84 patients were available for participation with a minimum 15-year follow-up. Any radiographic changes were documented. All additional procedures and complications were recorded. Clinical findings, self-reported performance and pain evaluations, and AOFAS ankle/hindfoot scores were noted. RESULTS: Metal implant survival was 73% at 15 years. Of the 24 patients available for clinical evaluation, 18 of 24 patients (70.7%) had no change in prosthetic alignment from the immediate postoperative radiograph. Only 1 subtalar fusion was required for symptomatic adjacent joint arthritis. Three patients sustained a broken polyethylene component. AOFAS scores improved from an average of 39.6 points preoperatively, to an average of 71.6. More than half (52.4%) of patients with retained implants required an additional surgical procedure; 3 required 2 additional procedures. The average time to subsequent procedure was 10.2 years. CONCLUSION: Our small cohort demonstrated STAR ankles with retention at 9 years were highly likely to survive to 15 years, and patients continued to have significant improvement in pain relief and minimal decrease in function. At 15 years from TAA, metal survivorship was 73%. 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