STAR Ankle Joint Replacement: An Option for Arthritis Pain

Are You a Candidate?

STAR ankle joint replacement may not be right for every patient. This surgery is ideal for those who suffer from persistent, severe arthritis ankle pain. You should have already tried other pain management techniques without sufficient relief before considering surgery. Your doctor will also need to evaluate the extent of the damage to your ankle. If you have a severe deformity or the joint is highly unstable, you may be unable to have this implant.

Patients who have already undergone arthrodesis of the ankle are ineligible for a STAR ankle. Tell your surgeon if you have ever had a deep infection in the ankle or surrounding bones. Patients with bone loss, or osteoporosis, may be unable to have this surgery, as insufficient bone mass may cause the implant to break.

Your doctor can tell you if you are a good candidate for surgery.

Preparation

After making the decision to undergo STAR ankle joint replacement surgery, you will need to take a few measures to prepare. Overweight patients will be advised to lose some weight prior to surgery to help ensure the success of the implant. If you are a smoker, you must stop smoking at least two weeks prior to your procedure.

You must also make arrangements to have someone help you around the house for at least the first two weeks following STAR surgery. You will not be able to place any weight at all on the ankle.

Discuss all your medications, over-the-counter drugs, and supplements with the surgeon. He may instruct you to discontinue some medications prior to surgery.

Do not eat or drink anything the night before surgery.

Procedure

STAR ankle joint replacement surgery requires the patient to be under general anesthesia. The surgeon will make incisions next to the joint. He can then remove the damaged bone.

There are three components to the STAR ankle. The first two components are made of a cobalt chromium alloy. One of them covers the lower ankle joint bone; the other covers the bottom end of your tibia, or shine bone. The third component is made of polyethylene. It is called a mobile bearing. The mobile bearing is located between the first two metal components. As you move your ankle, the mobile bearing moves with you, allowing a range of flexibility.

After implanting your new STAR joint, the surgeon will close the incisions.

Recovery

Expect to stay in the hospital for several days, keeping your foot elevated. The doctor will apply either a plaster cast or a boot to your foot and lower leg. You may not place any weight on the joint for the next two weeks; you will need crutches or a wheelchair. The surgeon will evaluate patients on a case-by-case basis. However, some patients can place full weight on the leg in about four weeks. Expect to have a cast on for about six weeks.

When you are recovered, you must still take care to prolong the life of your STAR joint implant. Avoid high-impact activities, like running and jumping.

Risks

The implant may wear out prematurely, particularly if you engage in high-impact activities. In this case, you'll need a replacement. Some patients have reported nerve injuries or a bone fracture in the area. Talk to your doctor about the risks before undergoing surgery.

References

STAR: Scandinavian Total Ankle Replacement

University of Iowa: Hospitals & Clinics