Endoprosthesis of the ankle joint. Indications and long-term results

The treatment of a post-traumatic, progressively more painful ankle joint causes increasing disablement. It might require alternatives to conventional surgery if a patient does not consent to ankle arthrodesis to alleviate the pain. Therefore, we report on a retrospective study of 10 patients (age 25-73 years at the time of surgery). All of them refused arthrodesis; thus 10 total ankle arthroplasties were performed between 1982 and 1989. 5 women and 5 men were treated who have been suffering from severe post-traumatic arthrosis for 3-46 years. Since performance of a single-axis arthroplasty (ICLH prosthesis) in each patient, the mean follow-up has been 4.6 years. One year after surgery, the results could be considered good or excellent in 9 of the 10 patients; only 1 person experienced local wound infection, which led to removal of the implant 4 months later and ultimately to arthrodesis. Two years later, 7 patients are eligible for follow-up because 1 underwent surgery in February 1989. Another patient experienced aseptic loosening after 18 months; he was admitted to our hospital for arthrodesis. Three years after endoprosthetic surgery, all except 1 woman with occasional pain and stiffness were found to have satisfactory results on follow-up. The relief of pain was gratifying in all patients, with ankle function well maintained (at least 0-0-30 degrees). At present, the prosthesis is still functional in 6 patients (surgery 1.5-8 years ago). They can go about their usual daily business without apparent pain and with appropriate function; 2 of them, however, show radiolucent lines on standard X-rays of the ankle, suggesting some loosening.(ABSTRACT TRUNCATED AT 250 WORDS)