Ankle arthritis has traditionally been treated surgically with arthrodesis (fusion) after conservative measures have been exhausted. The success of joint arthroplasty in the knee, hip, and shoulder inspired many attempts over the past 30 years to construct a workable ankle prosthesis. The failures of first generation prostheses caused skepticism regarding the feasibility of total ankle arthroplasty (TAR), but the mistakes of the past have been transformed into improvements and modifications. Today's second generation total ankle designs show promise, and outcomes are encouraging. The Agility Ankle (DePuy, Warsaw, IN) designed by Dr. Frank Alvine is featured in this article. The method of implant and postoperative management are reviewed.
