Management of varus or valgus ankle deformity with ankle replacement.

Ankle replacements are probably here to stay. Improved designs and surgical technique led to much better mid-term and longer term outcomes than the first-generation replacements in the 1970s. Multiple recent papers also have discussed the many potential complications with total ankle replacement surgery. As we proceed in the future, one should be cognizant of all the pitfalls and know how to deal with the difficult ankles, especially varus and valgus deformities. There should be a clear understanding that the greater the varus or valgus, the harder the procedure and the less predictable the outcome of ankle replacement.