How to avoid specific complications of total ankle replacement.

The design of the Agility total ankle replacement (DePuy, Warsaw, IN) has improved in an effort to address the biomechanic challenges of the ankle joint. Certainly further laboratory investigation and clinical trials with ankle replacement are needed to improve its position as the major alternative to ankle arthrodesis. As the science behind the ankle implants has evolved during the last 15 years, so has our experience and understanding of some crucial factors predisposing to an unsuccessful outcome. Complications such as postoperative stiffness, prosthesis subsidence, and residual deformity along with infection and wound healing problems jeopardize a successful outcome. Adequate knowledge of anatomy and biomechanics, careful preoperative evaluation and planning, and strict attention to operative details help minimize the incidence of these complications.