Ankle replacement: management of associated deformities.

Ankle arthroplasty is emerging as an alternative to arthrodesis. Restoring and maintaining proper bony alignment and muscle balance in the limb is essential if there is to be any chance for long-term survival. Deformity can arise above the ankle, in the joint itself, or in the foot. Secondary procedures in the foot and leg, including osteotomies, fusions and muscle balancing, are performed either before or simultaneously with ankle replacement.