The indications for total ankle-replacement arthroplasty are
controversial. Some preliminary experience with its use in patients with
rheumatoid arthritis has been disappointing. However, in our fifteen
single-axis arthroplasties, fourteen of the Mayo and one of the Buchholz
type, after an average follow-up of thirty-nine months seven ankles were
rated excellent and eight, good. The relief of pain was gratifying in all
of the patients, only four patients having residual slight pain with
starting activity. The average gain in the range of motion was 9 degrees.
No patient had loosening that required reoperation, although radiolucent
lines were seen in eleven ankles. Thirteen of the fifteen ankles had
moderate to severe arthritic changes in the talonavicular, subtalar, or
other intertarsal joints.