Purpose: What is the clinical and radiographic outcome of arthrodeses
at the hindfoot and at the ankle more than 10 years postoperatively? M
ethods: Between 1968 and 1988, 155 arthrodeses (ankle joint, triple ar
throdeses, subtalar, pantalar and talonavicular arthrodeses) were perf
ormed on 147 patients. Indications for arthrodesis were posttraumatic
arthritis, congenital deformity, idiopathic degenerative arthritis and
rheumatoid arthritis. A variety of internal fixation devices or no in
ternal fixation were used. 79 patients with 82 arthrodeses were reexam
ined clinically and radiographically, after 11,1 years on average. Sta
tic and dynamic foot print measurements were recorded with a capacitiv
e sensor system. Another 26 patients with 27 arthrodeses replied to a
questionnaire. Results: Subjectively, the average pain score improved
significantly. The overall function score improved only slightly. Resu
lts were inferior in the talonavicular arthrodesis. Radiographic evalu
ation revealed bony union in only 59 percent of the arthrodeses, one t
hird at the talonavicular joint. Secondary degenerative arthritis of t
he foot and ankle occurred in 107 joints of the 82 feet. Evaluation of
dynamic foot pressure measurements revealed an overall prolonged weig
htbearing on the midfoot region. Conclusion: An unacceptably low rate
of bony union in some locations, a high incidence of secondary degener
ative changes at neighboring joints, and a persistent abnormality of t
he plantar weightbearing pattern in the operated feet demonstrate unsa
tisfactory results with the techniques used more than 10 years ago. We
now recommend stable internal fixation with-optimum adaptation of the
bone surfaces of the arthrodesis.