Management of arthritis of the ankle. An alternative of arthrodesis

Twenty-eight patients treated by total ankle arthroplasty at the University of California, Irvine, were evaluated on a 100-point ankle analysis scale preoperatively and postoperatively. The average preoperative score was 35 and the average postoperative score was 74. Significant improvement occurred in function, pain relief and range of motion. The average follow-up period for these patients was 9 months. Although the number in each group is small, it does not appear that the procedure has merit for the treatment of ankle arthritis from such diverse causes as trauma, rheumatoid arthritis, aseptic necrosis of the talus and talectomy. Complications included wound healing problems in 3 patients. Malalignment of the prosthesis occurred in 2 other patients; one required revision. Ankle replacement failed in 2 patients. One patient required a fusion; the other an amputation following occlusion of the posterior tibial artery after surgery. At the present time, ankle replacement appears to be an acceptable alternative to ankle arthrodesis.