Total ankle replacement in rheumatoid arthritis.

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.