Aims: Tibiotalar fusion is considered as gold standard for end-stage posttraumatic arthritis of the ankle. This study analyses the long-term results after talar joint fusions, especially the health related quality of life, correlated to the clinical and radiological results. Methods: We examined 16 males and 1 female patient, with 18 ankle fusions, clinically, radiographically and in regard of quality of life with the SF-36 Health Survey after a minimum follow-up period of 20 years (mean 23, range 20–33). Mean age at operation was 37 years (SD=8y), at follow up 61 years. Between injury and arthrodesis was an interval of six years in average. In eleven cases an external þxation was used. Results:. Subjectively 50% were not handicapped performing daily life activities and 44% were in the same job as at the time of injury. Out of 11 complications, the most frequent one was wound infection in seven cases (68%). On clinical examination þve feet were stiff at the forefoot. Eight patients had 25%, three had 50%, one had 75% and one the full range of motion. We found one valgus and seven varus deformities of the ankle. Following roentgenographic measurements with the MORREY as well as the TAKAKURA score, degenerative arthritis in the subtalar and Chopart joints was 2.7 (SD=0.77). The mean OMA score was 59.4 points, the visual analogue scale was 1.99, the radiologic score was 2.7 and the SF-36 revealed for physical functioning, emotional role functioning and bodily pain signiþcant deþcits. A signiþcant correlation was found between the OMA and the radiological score at 0.05, and between the clinical and the SF-36 score at 0.01. No correlation was found between the radiologic score and the SF-36 questionnaire. Conclusion: Ankle arthrodesis leads to deþcits in the functional outcome, to limitations in the activities of daily living and to roentgenographic changes in the adjoining joints. The clinical outcome and the SF-36 score correlate tightly.

Tibiotalar fusion is considered to be the standard treatment for end-stage post-traumatic arthritis of the ankle. We report a retrospective, objective long-term study of the quality of life of 17 patients with 18 arthrodeses of the ankle, over a period of more than 20 years. We looked particularly for correlation between clinical and radiological signs of osteoarthritis in adjoining joints. At serial physical examinations, clinical grades were awarded according to the Olerud Molander Ankle (OMA) score. Any degree of degenerative change in the adjoining joints was recorded on standing radiographs. Patients filled out a SF-36 Health Survey form.

Subjectively, 50% of patients were not handicapped in the performance of daily activities and 44% were in the same job as at the time of injury. At follow-up the mean OMA score was 59.4 points, the visual analogue scale was 1.99 and the radiological score was 2.7. The SF-36 for physical function, emotional disturbance and bodily pain revealed significant deficits. There was a significant correlation between the OMA and the radiological score (p = 0.05), and between the clinical and the SF-36 score (p = 0.01), but no significant correlation between the radiological score and the SF-36 score.

Arthrodesis of the ankle leads to deficits in the functional outcome, to limitations in the activities of daily living and to radiological changes in the adjoining joints. The clinical outcome score correlates closely with the SF-36 score.