Survival Analysis of the Single- and Double-Coated STAR Ankle up to 20 Years

Abstract

Background: The Scandinavian Total Ankle Replacement (STAR) has been used widely in Europe and more recently in the United States. We studied the results of the single-coated and the double-coated STAR with long-term follow-up. Methods: All STARs (n = 324) used in Sweden (first implanted in 1993) were included. Prosthetic survival was estimated according to Kaplan-Meier. Results: The 14-year survival of the single-coated STAR was 0.47 (95% confidence interval [CI], 0.38-0.66), and the 12-year survival of the double-coated STAR was 0.64 (95% CI, 0.57-0.71). Women younger than 60 years with osteoarthritis had a statistically significantly higher risk of revision than men and than patients with other diagnoses. Conclusion: The long-term results of the STAR prosthesis are not encouraging. The results seem to deteriorate by time. Level of Evidence: Level IV, retrospective case series.