Total ankle replacement in rheumatoid arthritis: a preliminary review of 28 arthroplasties in 24 patients.

Twenty-eight arthroplasties performed during a period of three and a half years during 1976-1980 were evaluated after an average follow-up period of 21 months. All patients had advanced rheumatoid arthritis. The Richard's prosthesis was used in 22, the ICHL prosthesis in five and St. George prosthesis in one instance. The results were in general satisfactory, particularly as to pain relief, yet there was only limited improvement in the actual range of movement. All ankles were stable: nevertheless loosening could be demonstrated radiologically and clinically in 5 out of 56 prosthetic components. No revisions have been warranted so far. In strictly selected cases, replacement arthropolasty seems a worthwhile alternative to arthrodesis in patients with severe rheumatoid arthritis in many weightbearing joints.