Total Ankle Replacement: Past, Present, and Future.

Total ankle replacements have made profound progress with respect to kinematics, biomedical technology, engineering, and surgical technique since its inception nearly 50 y ago. Though it may never completely usurp tibiotalar arthrodesis as the gold standard for end stage arthritis, ankle arthroplasties continue to evolve in their capacity to offer a legitimate alternative with quality patient outcomes. Given the multitude of anatomic and biomechanical challenges intrinsic to the ankle joint, patient-specific surgical planning, advanced imaging, and equipment are invaluable in yielding successful implantation and long-term retention.