Chang CB, Chung CY, Park MS, et al. - This research was intended to assess the change in ankle varus incongruencies following total knee replacement (TKR) in patients with preoperative genu varum deformity of ≥10°. This research has consisted of patients who had undergone TKR in a single institution for knee osteoarthritis with preoperative genu varum deformity of ≥ 10° and concomitant varus ankle incongruencies. This analysis included a sum of 110 patients (male=2; female=108). As per the results, varus ankle incongruencies exhibited aggravation following TKR despite the correction of genu varum deformity and restoration of the mechanical axis. It was considered that this could be an important cause of postoperative increase or development of ankle pain following TKR. Thus, individuals with preoperative varus ankle incongruencies required to be warned of possible aggravation of ankle symptoms and be assessed before TKR.