The AGILITY ankle has been clinically used for over 20 years and between the two authors, a total of 1,075 AGILITY ankles have been inserted. Beside concept and design of this unique ankle prosthesis, specific follow-up data will be presented on 775 implants performed by the first author (FGA). The AGILITY Ankle System can give reliable and predictable results if the surgeon is aware of the complexity of this operation and the need for careful postoperative monitoring. Many of the failures that have occurred in the Agility System can be prevented by early detection (i.e., syndesmotic nonunion, hindfoot valgus, fractures, etc.) and if the problem is corrected, the implant can be maintained. The new LP System will also add another dimension to the overall adaptability of the prosthesis for an additional broader base of patients.