1. Can ankle joints be replaced? The literature on ankle replacement includes many countries, no one has performed a comparative analysis, and their conclusions are based on first-generation ankle prostheses. There are several common problems: they do not understand normal ankle kinematics, they remove too much bone, they alter the plane of the ankle axis, and they do not correct angular deformities of the ankle joint. These results led many surgeons to abandon ankle replacement. Today, many scholars have adopted second-generation ankle prostheses and have followed up on them, and through the analysis of follow-up studies, the attitude of multiple orthopaedic centers toward ankle replacement has easily changed, and now it seems that ankle replacement is entering a new era. It may eventually have the same good results as other weight-bearing joints. However, ankle replacement is more demanding than other weight-bearing joints, partly because the anatomy and kinematics of the ankle are more complex, and partly because most orthopedic surgeons have more difficulty getting many patients who need ankle replacement, so the risk is forever stuck on the learning curve. 2. Can’t ankle replacements be used in young people? In a foreign study of 100 patients with osteoarthritis and rheumatoid arthritis, 30 patients were under 50 years of age and 70 patients were over 50 years of age. The mean age of the first group was 43 years and the mean age of the second group was 64 years (range 51-83 years). The mean follow-up time was 7 years in both groups. The distribution of osteoarthritis and rheumatoid arthritis was the same. Failure was considered to require ankle revision (for whatever reason) and arthrofusion, and Table 2 below shows the causes and distribution of failure in the two groups, with no significant differences in survival analysis comparisons. As with any other artificial joint, young people should recognize that to prolong the use of an ankle replacement prosthesis, strenuous exercise should be avoided. 3. Is ankle replacement best suited for patients with rheumatoid arthritis? In a long-term comparison of pain, function and activity in patients with RA and OA, Kofoed and his colleagues confirmed that there was no difference between the OA and RA groups, with OA patients having a more rigid course and RA patients having mildly reduced activity after many years. For pain relief the two groups were the same. 4. Can’t ankle replacement correct an angular deformity of more than 10? With the osteotomy technique described by Kofoed, it has been possible to correct angular deformities such as valgus or valgus. Correction of these deformities improves the position of the ankle joint, which is common in patients with rheumatoid joints. Ankle replacement can correct and improve large deformities. 5. Is there any reason to believe that the results of uncemented prostheses in ankle replacement are better? Given the difficulty of cemented tibial prostheses and the risk of protruding cement entering a very narrow joint space, this is the theoretical basis for believing that uncemented ankle replacements are better. It has been shown that the retention rate of uncemented prostheses is significantly higher than cemented prostheses at the 7-year follow-up of Jane. Therefore, we conclude that: ankle prostheses should be non-cemented.