History of total ankle replacement.

Attempts at ankle replacement have existed for at least 50 years. Time has essentially eliminated constrained, cemented, first-generation ankle replacements. Although some two-component, more anatomic, designs are still used with varying success, three-component "mobile bearing" ankle prostheses are winning the race of evolution. Not only have implants change over the years, but also the patients and surgeons. Surgeons specialize, improving their surgical outcomes and expanding the indications for total ankle replacement in technically demanding complex ankles. High-demand, younger patients, but also obese ones, are potential candidates for a total ankle replacement. This article provides a review of the history of total ankle replacement.