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Intermediate clinical and radiographic results of the new generation of total ankle arthroplasties have been encouraging. Many of the devastating problems of earlier designs have been avoided, yet these newer implants are not without complications. Many problems can be avoided with careful preop-erative planning and by paying meticulous attention to technique during implantation. Common pitfalls with the implantation process of the Agility Total Ankle Replacement (DePuy, Warsaw, Ind) are discussed. The diagnosis and treatment of complications occurring intraoperatively and in the intermediate- and longer-term postoperative period are outlined, with recommendations on how to avoid them.