Since July 1980, 12 cases of total ankle replacement and 2 cases of total ankle and talus replacement have been performed with the self-designed prosthesis. The age of patients ranged from 23 to 62, average 35.6 years. 12 patients were subject to long-term followup, the average follow-up time was 8 years and 7 months. 8 out of them were followed up for more than 10 years. According to McGuire standard, the results of the 12 were excellent in 9, good in 2, unapplicable in 1 with adjacent joint restriction. All the 11 patients resumed their original occupation with relief of clinical symptoms and great improvement of joint motion. Hence, we conclude that whenever a patient shows an indication for ankle arthrodesis, total ankle replacement can be of our first trial in some of them after overall consideration of the operative indications.