Total ankle arthroplasty in valgus ankle osteoarthritis

The valgus total ankle replacement (TAR) presents a considerable challenge and tests the skill and ingenuity of even the most accomplished foot and ankle surgeon. Coronal plane deformity used to be considered a relative contra-indication for TAR, however with implant innovation and greater surgical understanding, the indications for TAR in deformity continue to expand. Success requires a bespoke approach to each patient to ensure that intra- and extraarticular deformities and imbalance are adequately addressed to avoid TAR failure. The overall goal in TAR surgery is achieving a well aligned and stable ankle with a well aligned and stable foot below. This article presents some of our strategies to achieve this when considering TAR in the valgus ankle.