STAR prosthetic system and the biomechanical considerations in total ankle replacements

The ankle is a complex joint that plays a crucial role in our ability to move. It has many parts that work together, including bones and ligaments. Over time, the ankle can become damaged due to injury or wear and tear, making it difficult to walk and move around. Traditionally, surgery to fix a damaged ankle involved fusing the bones together. However, newer treatments, like total ankle replacement (TAR), are now available.

Understanding Ankle Biomechanics:

To understand TAR better, it’s important to know how the ankle works. The ankle joint experiences a lot of stress and pressure during movement, so any replacement system needs to be designed with this in mind. This review explores how TAR systems have evolved over time to better mimic the natural movement and function of the ankle.

Evolution of Ankle Replacement Systems:

Ankle replacement surgery is a relatively recent development compared to traditional fusion surgery. This section looks at the history of ankle replacement and how different prosthetic systems have been designed to improve patients’ mobility and reduce pain.

The Scandinavian Total Ankle Replacement (STAR):

One specific TAR system, called the Scandinavian total ankle replacement (STAR), is discussed in detail. This system consists of three components and is designed to closely match the natural anatomy and movement of the ankle. The review evaluates whether the STAR prosthesis effectively distributes stress across the joint and meets the biomechanical needs of the ankle.

The ankle is made up of three bones, various ligaments, tendons, and muscles. The talus bone sits within a groove formed by the tibia and fibula, while the tibia and fibula form the inner and outer ankle bones, respectively. This arrangement creates a stable structure that allows for movement in multiple directions, rather than just up and down like a simple hinge. Understanding the complex anatomy of the ankle is important for treating ankle injuries effectively.

Conclusion:

In summary, this discussion has focused on how the ankle joint distributes stress during movement. Forces acting on the ankle can be broken down into different types, including compression, shear, and torsion. As ankle replacement surgery becomes more common, it’s essential to consider how prosthetic designs can accommodate these forces to ensure optimal function and longevity. While there is still some conflicting evidence, features like minimal bone removal during surgery and appropriately sized implants are crucial considerations for successful outcomes.

Do you have more questions?Ā 

What are the potential risks and complications associated with the STAR Prosthetic System?

Potential risks and complications associated with the STAR Prosthetic System include infection, implant loosening, fracture, nerve injury, and improper alignment leading to joint instability.

What is the expected lifespan of the STAR Prosthetic System?

The expected lifespan of the STAR Prosthetic System varies depending on factors such as patient age, activity level, and implant positioning, but it typically lasts around 10 to 15 years before potential revision surgery may be needed.

How does the STAR Prosthetic System compare to other total ankle replacement systems in terms of clinical outcomes and patient satisfaction?

Clinical outcomes and patient satisfaction with the STAR Prosthetic System compared to other total ankle replacement systems may vary depending on factors such as surgeon experience, patient selection, and surgical technique.

Are there any specific pre-operative considerations for patients undergoing total ankle replacement with the STAR Prosthetic System?

Pre-operative considerations for patients undergoing total ankle replacement with the STAR Prosthetic System may include medical optimization, assessment of bone quality, and discussion of expected outcomes and rehabilitation goals.

What is the surgical technique for implanting the STAR Prosthetic System?

The surgical technique for implanting the STAR Prosthetic System involves removing damaged cartilage and bone from the ankle joint and replacing it with the prosthetic components, ensuring proper alignment and stability.

How long does it take to recover from total ankle replacement surgery using the STAR Prosthetic System?

Recovery from total ankle replacement surgery using the STAR Prosthetic System varies among patients but typically involves several weeks of protected weight-bearing followed by physical therapy to regain strength, flexibility, and mobility.

Can the STAR Prosthetic System be used in patients with severe ankle deformities or bone loss?

The suitability of the STAR Prosthetic System for patients with severe ankle deformities or bone loss depends on the specific anatomical considerations and may require additional surgical techniques or modifications.

Are there any age restrictions for undergoing total ankle replacement with the STAR Prosthetic System?

There are typically no strict age restrictions for undergoing total ankle replacement with the STAR Prosthetic System, but candidacy may depend on overall health, functional status, and expected benefits versus risks.

How soon can patients return to daily activities and sports after total ankle replacement with the STAR Prosthetic System?

The timeline for returning to daily activities and sports after total ankle replacement with the STAR Prosthetic System depends on individual factors such as healing, rehabilitation progress, and surgeon recommendations.

What is the role of physical therapy in the post-operative recovery process for patients with the STAR Prosthetic System?

Physical therapy plays a crucial role in the post-operative recovery process for patients with the STAR Prosthetic System by promoting joint mobility, strength, balance, and gait training to optimize functional outcomes.

How frequently should patients follow up with their orthopedic surgeon after total ankle replacement with the STAR Prosthetic System?

Patients typically follow up with their orthopedic surgeon regularly after total ankle replacement with the STAR Prosthetic System to monitor healing, address any concerns, and assess long-term outcomes.

What are the signs of potential complications that patients should watch for after total ankle replacement with the STAR Prosthetic System?

Signs of potential complications after total ankle replacement with the STAR Prosthetic System include persistent pain, swelling, redness, warmth, instability, or any unusual sensations around the ankle joint.

Can the STAR Prosthetic System be revised or removed if necessary due to complications or implant failure?

Yes, the STAR Prosthetic System can be revised or removed if necessary due to complications or implant failure, but revision surgery may be technically challenging and require experienced orthopedic surgeons.

How does obesity or other comorbidities affect the outcomes of total ankle replacement with the STAR Prosthetic System?

Obesity and other comorbidities may increase the risk of complications and negatively impact the outcomes of total ankle replacement with the STAR Prosthetic System, highlighting the importance of medical optimization and risk assessment.

Are there any lifestyle modifications or restrictions that patients should follow after total ankle replacement with the STAR Prosthetic System?

Patients may need to adhere to lifestyle modifications or restrictions after total ankle replacement with the STAR Prosthetic System, such as avoiding high-impact activities, maintaining a healthy weight, and wearing supportive footwear.

What are the long-term outcomes and survivorship rates of total ankle replacement with the STAR Prosthetic System?

Long-term outcomes and survivorship rates of total ankle replacement with the STAR Prosthetic System vary among studies but generally show favorable results in terms of pain relief, functional improvement, and implant longevity.

How does the STAR Prosthetic System address biomechanical considerations specific to the ankle joint?

The STAR Prosthetic System is designed to address biomechanical considerations specific to the ankle joint by restoring physiological motion, joint stability, and load distribution to facilitate natural gait patterns and function.

Are there any ongoing research or advancements in the field of total ankle replacement with the STAR Prosthetic System?

Ongoing research and advancements in the field of total ankle replacement with the STAR Prosthetic System focus on refining surgical techniques, optimizing implant design, and improving patient selection criteria to enhance outcomes and longevity.

How does the cost of total ankle replacement with the STAR Prosthetic System compare to other treatment options for end-stage ankle arthritis?

The cost of total ankle replacement with the STAR Prosthetic System may vary depending on factors such as healthcare facility, surgeon fees, insurance coverage, and post-operative care, but it is generally comparable to other surgical interventions for end-stage ankle arthritis.

What are the patient-reported outcomes and satisfaction rates following total ankle replacement with the STAR Prosthetic System?

Patient-reported outcomes and satisfaction rates following total ankle replacement with the STAR Prosthetic System are generally positive, with many patients experiencing improved pain relief, function, and quality of life compared to pre-operative status.

Dr. Mo Athar
A seasoned orthopedic surgeon and foot and ankle specialist, Dr. Mohammad Athar welcomes patients at the offices of Complete Orthopedics in Queens / Long Island. Fellowship trained in both hip and knee reconstruction, Dr. Athar has extensive expertise in both total hip replacements and total knee replacements for arthritis of the hip and knee, respectively. As an orthopedic surgeon, he also performs surgery to treat meniscal tears, cartilage injuries, and fractures. He is certified for robotics assisted hip and knee replacements, and well versed in cutting-edge cartilage replacement techniques.
In addition, Dr. Athar is a fellowship-trained foot and ankle specialist, which has allowed him to accrue a vast experience in foot and ankle surgery, including ankle replacement, new cartilage replacement techniques, and minimally invasive foot surgery. In this role, he performs surgery to treat ankle arthritis, foot deformity, bunions, diabetic foot complications, toe deformity, and fractures of the lower extremities. Dr. Athar is adept at non-surgical treatment of musculoskeletal conditions in the upper and lower extremities such as braces, medication, orthotics, or injections to treat the above-mentioned conditions.