Ten Year Experience with the STAR Total Ankle Replacement

Panarab 2010 Marrakech Ten year experience with the STAR total ankle replacement Christian A. Kinast , Johannes Hamel Orthopedic Center Arabellapark Munich www.oza-m.de

STAR – total ankle replacement C.Kinast - Munich Germany Malalignement of the TAR Soft tissue balancing in ankle malalignement

STAR loosening / complications C.Kinast - Munich Germany Literature: 5 – 13 % Kofoed Hintermann Woods Valdeberano
OZA Munich Kinast Hamel
N = 253
Exchange
Fusion ( diabetes )
Large subsidence talar component
skinnecrosis 5 plastic surgery
revisions: soft tissue balancing , ossifications

C.Kinast - Munich Germany Frohmader 67 mt p.o. STAR periarticular ossifications

STAR tibial plate osseus reactions C.Kinast - Munich Germany Trabeculae centered to the bolts Male 70y 9 y postop ? subsidence of talar component

STAR talar component C.Kinast - Munich Germany Cystic lesions Cystic lesions 61 y male 10y postop

STAR - alignement – additional osteotomies C.Kinast - Munich Germany

STAR soft tissue balancing C.Kinast - Munich Germany Varus : distal advancement of the med. mall. ptt lengthening , n. tibialis release att transfer to the lat cuneiforme per.long. tend. transfer to the fibula

STAR - alignement changes C.Kinast - Munich Germany Angerer calcaneus osteotomy, dorso-med. release, ant tib. tendon transfer , per. Long to brevis transfer

STAR soft tissue balancing C.Kinast - Munich Germany ant tibial tendon transfer n= 32 Hamel J: Fuss & Sprungg 2008

Grgas Balanced foot after attt Lit.: no TAR over 15° varus

STAR soft tissue balancing C.Kinast - Munich Germany Valgus: forefoot plantarisation TN-fusion TC-fusion

STAR soft tissue balancing C.Kinast - Munich Germany Schaller valgus ankle talar cyst

Schaller 1y p.o. Tal-calc fusion bonebloc, plant. Lapidus-Arthrodesis

Conclusions
in standard cases the TAR is a surface replacement close to anatomic conditions
in malalignement additional softtissue balancing is mandatory
bony and soft tissue additive procedures are nessecary to balance the TAR in a neutral position of muscles, ligaments and tendons
Early revision is preferable in cases of developing malalignement
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Orthopedic Center Arabellapark Munich center for foot and ankle center for hip center hand and elbow center for spine and pain therapy www.oza-m.de

Ten Year Experience with the STAR Total Ankle Replacement

by Christian Arno Kinast on Jan 11, 2012

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Ten Year Experience with the STAR Total Ankle Replacement Presentation Transcript

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