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Home / Orthopedics / Innovation and Technology Give Ankle Implants Resurgence

Innovation and Technology Give Ankle Implants Resurgence

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Total knee and hip replacement implants have been used with success for years, but ankle implants have had a long history of failure. In the late ’70s and early ’80s the ankle implants wore out, popped out or collapsed into the bone. Ankle implant surgery disappeared, for the most part, for almost two decades, with surgeons recommending an ankle fusion for those patients with severe pain and disability due to ankle arthritis. In the earlier part of this decade, ankle implants have started to make a resurgence with the new emerging technology.

Why the failures? Early ankle replacement devices were fixed to the bone with cement. The fixation was lost with the excess shearing forces causing the bone support to fail. Compared with the hip and knee joints, the ankle joint has a much smaller surface with much greater weight to support and greater shearing forces.

An ankle fusion, the current standard of care for surgical treatment of chronic ankle pain due to arthritis, is limiting because of the lack of motion at the ankle after the procedure. The newer ankle implant devices have higher success rates than the older models. There are many two component implants on the market and currently being used, including the Inbone Total Ankle Replacement (Wright Medical Technology), Agility Total Ankle System (DePuy), the Eclipse Total Ankle Implant (Kinetikos Medical, Inc.) and the Salto-Talaris Total Ankle Prosthesis (Tornier).

Mobile bearing, three component ankle replacement systems have been under review and in clinical trials. Entering the market, but still under review, are the Buechel-Pappas Ultra Total Ankle Replacement (Endotec) and Hintegra Total Ankle Replacement (Integra). The S.T.A.R. (Small Bone Innovations, Inc) total ankle replacement system was approved by the FDA in May, 2009, for ankle joint replacement due to osteoarthritis, post-traumatic arthritis or rheumatoid arthritis. The advantage of the mobile bearing system is the third component, made of polyethylene, a medical grade plastic. This insert allows for translation and rotation and decreases excess shearing and breakdown of the polyethylene, common in the two-component systems. Excess shear and stress on the interface between the metal component and the bone can lead to implant failure.

Small Bone Innovations, Inc. (SBi) notes that the S.T.A.R. ® Ankle has been in development for 30 years and the most recent design has been implanted in over 15,200 patients around the world. There have been thirty-five peer-reviewed outcomes papers published on the S.T.A.R. ® Ankle replacement device.

In August of 2000, a U.S. IDE Trial of S.T.A.R.® was initiated to evaluate and safety and effectiveness of the device. The 2 year, prospective, multi-center controlled study evaluated 670 patients and compared the S.T.A.R. implant to joint fusion surgery. The results showed superior efficacy and safety with the S.T.A.R. ® Ankle compared to ankle fusion.

The Scandinavian Total Ankle Replacement (S.T.A.R.) system is a 3- component, mobile bearing device, approved for use without cement. The first component is designed to fit into the tibia, the bottom portion of the shin bone. The second component is designed to fit on the talus, also known as the ankle bone. The third component is called the UHMWPE Sliding Core, the mobile bearing made of medical grade plastic. The Sliding Core is designed to move between the two metal components, to simulate normal ankle joint motion.

Indications for ankle joint replacement systems include severe pain and loss of mobility and function due to post traumatic arthritis, ankle osteoarthritis and rheumatoid arthritis.

Hospitals in UAE : Search the UAE's leading medical clinics and doctors in UAE by medical specialty, spoken language, availability & insurance. List of best medical clinics & hospitals in Dubai, Abu Dhabi, Sharjah, Ajman, Al Ain, Dubai, Fujairah, RAK, Sharjah. Find a doctor in Dubai, Abu Dhabi, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah. List of best hospitals & clinics in UAE.

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Everything you need to know! reviews, ratings, analysis of top hospitals & clinics in Dubai, Abu Dhabi, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah. List of UAE hospitals, medical and health facilities, clinics, healthcare centers in Dubai, Abu Dhabi, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah.

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Medical care in Dubai and the UAE varies, as anywhere, from poor to excellent. The UAE has about 35-40 Government hospitals and a similar number of private hospitals although with developments like Dubai Healthcare City (DHCC), there is rapid expansion in the number of private institutes ready to fix your bones and take your blood. Additionally, there are 150 or more Primary Healthcare Centers in the UAE.

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Government hospitals in UAE often get a bad rap but in terms of medical attention, this is perhaps a bit harsh, notwithstanding the press reports of less than satisfactory medical attention. You will probably find the biggest difference between government and private hospitals is "Customer Service" for want of a better term. Dormitory style rooms rather than private hotel rooms are the norm, and staff shortages mean nurses especially, are overworked and underpaid. But you will usually get the medical attention you need, at least in Dubai and Abu Dhabi anyway. Sometimes, for major medical procedures, a private hospital will ship you off to a government hospital anyway.

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In the other emirates medical treatment might be more questionable, and it is common for residents in those emirates to go to Abu Dhabi or Dubai for medical procedures, especially major ones. Communication in English might also be difficult in more remote areas, depending on the nationalities of the doctors, nurses, technicians, and other staff. Communication in Arabic might be difficult, also dependent on the nationality of staff you're talking to - many hospitals employ doctors and nurses who might not speak any Arabic, but usually non-Arab nationalities employed all speak English, as do the majority of Arab nationalities employed, especially in Abu Dhabi and Dubai private hospitals.

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