Correction of Moderate to Severe Coronal Plane Deformity with the STAR™ Ankle Prosthesis

Abstract

Correction of moderate to severe coronal plane deformity with the STAR prosthesis was achievable with only soft-tissue balancing procedures with predictable results especially for deformities less than 25 degrees.

Differences in Outcomes Following Total Ankle Replacement in Patients with Neutral Alignment Compared with Tibiotalar Joint Malalignment

“…With use of this reasoning, coronal plane deformity exceeding 15°of varus or valgus often has been cited as a contraindication to total ankle replacement [26][27][28] . Prohibiting this population of patients from receiving a total ankle replacement eliminates a large proportion of those who might benefit from this procedure.…”

Osteotomies for Managing Varus and Valgus Malalignment with Total Ankle Replacement

“…Interestingly, Reddy and colleagues 24 showed that preoperative varus deformity of greater than 10 in 43 ankles, treated with the Scandinavian TAR (Waldemar Link, Hamburg, Germany/Small Bone Innovations, Inc, Morrisville, PA/Stryker Orthopedics, Mahwah, NJ) were corrected with soft tissue procedures only, without performing osteotomies. However, 3 ankles with deformity greater than 25 failed.…”

“…8,9,[19][20][21][22][23][24][25][26] One cannot isolate many studies reporting on outcomes of TARs combined with osteotomies, as these procedures are part of the whole spectrum of surgery performed for ankles with greater than 10 coronal plane deformity. Doets and colleagues 20 reported on his series of 15 TARs in varus ankles, requiring a medial malleolar lengthening osteotomy.…”

“…[3][4][5][6][7][8][9] Some surgeons have, however, expanded the indications of TAR to include ankles with preoperative deformity of 15 or more, performing adjunctive procedures to correct coronal plane alignment and stability (eg, subtalar or triple arthrodesis, osteotomies, soft tissue releases, and ligament reconstructions). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] We present the rationale, surgical techniques, and outcomes of re-alignment osteotomies that have been described (ie, medial malleolus, fibula, distal or proximal tibia, calcaneus, first metatarsal) as adjunctive procedures performing TAR for deformed ankles. This article focuses on coronal plane deformities, but one has to bear in mind that ankle deformity rarely occurs in one plane only.…”

Will Total Ankle Arthroplasty Become the New Standard for End-Stage Ankle Arthritis?

“…Moderate to severe coronal ankle malalignment has been considered a con- n guest editorial traindication for TAA and is currently a heavily debated topic. 13,14 New investigations are demonstrating better predictability for more significant coronal plane deformities through a structured and thoughtful approach, occasionally requiring staged reconstructions. 15 Expanded indications to include younger patients with increasing deformity have been recently implemented with success.…”