We aim to assess the outcome of ankle arthrodesis performed for painful osteoarthritis in the presence of a coronal plane deformity of 20 degrees or more. To our knowledge this is the first reported series of such a cohort of patients. We have a consecutive and complete series of 24 patients with 26 ankle arthrodeses which were all performed for painful osteoarthritis in the presence of large coronal plane deformity. These patients have a minimum of twelve months clinical follow up. The results showed a low non union rate of 8% (2 ankles). These have subsequently been refused satisfactorily, and were excluded from further analysis. The results of the remaining 24 ankles which united primarily show that they were very pleased with the outcome of their surgery. AOFAS scores were used to measure pain and function both pre operatively and post operatively. These scores showed large improvements for both pain and function, and had a high statistical significance (p< 0.0005). All patients improved in their walking distance and many patients reduced their need for walking aids. Stair climbing ability was also improved in some patients. It is recognised that an ankle arthrodesis usually relieves pain but does not result in a normal gait and full function. We feel that the high level of patient satisfaction in this series was due to the combination of deformity correction, restoring a functional foot position, and achieving a painless ankle. Arthroplasty of the ankle is a good procedure for relief of pain and restoration of function. However In the presence of a large coronal plane deformity ankle arthroplasty is known to fare badly with early failure. Therefore for patients with painful osteoarthritis and a coronal plane deformity of 20 degrees or more, we recommend ankle arthrodesis as the procedure of choice.

Aims: To determine the clinical, radiological and sur-vivorship results of a series of 200 cementless STAR total ankle replacements. Methods: 200 consecutive total ankle replacements were prospectively entered into the study. There were 119 with inßammatory joint disease and 81 with osteoarthritis. Mean follow up was 46 months (24 to 101). No ankles were lost to follow up for reasons other than patient death. All ankles were clinically assessed with AAOFAS scores and radiologically assessed within a year of the results being analysed. Results: Fouteen ankles were revised or fused. Eight ankles required further surgery to resolve a complication. The cumulative survival rate at 5 years was 92.7% using time to decision to revise or fuse the joint as the endpoint. The most frequent complications were wound healing problems and malleolar fracture. This became less common as experience was gained. Conclusions: These midterm results are promising but the authors do not advocate ankle replacement in all those with degenerative disease of the ankle