We evaluated the results in thirteen patients with disabling tibiotalar arthritis who underwent a new operation for ankle fusion for relief of pain. The procedure in all of these patients was a chevron (pitched-roof) tibiotalar osteotomy and excision of the joint. A bilateral approach to the ankle joint was used and the arthrodesis was supplemented by internal fixation and a tibial onlay graft applied medially. There were few complications, none of them of major importance. The after-care required only immobilization in a short cast. All but one patient had a solid fusion. The final result was a normal-looking ankle with good function.