Objectives: After more than 10 years' experience in France, the French Foot Surgery Association (Association francaise de chirurgie du pied [AFCP]) presents an update on mobile-bearing ankle prostheses, based on a multicenter study. Meta-analysis - Biomechanics - Assessment and indications: A preliminary comparative metaanalysis of the literature studies on ankle and prosthesis biomechanics, reviews validated indications and contra-indications, and details clinical and radiological outcomes assessment protocols. Professional survey: Sixty-three surgeons (95% AFCP members) answered a professional online survey, by email or regular post: 70% performed total ankle replacement (TAR), 39% of them at least two per year and 16% more than 10 per year, resulting in 317 TARs per year or 50% of the French activity and 312 arthrodeses per year or 17% of the French activity - which gave the survey considerable power. In 2004-2005, 46% of the TARs implanted were AES®, 38% Salto® and 9% Hintegra®. Gait analysis following TAR: This study included two series of patients (15 in Brussels and six in Paris) with laboratory gait analysis preoperatively and at 6 months' and 1 year's FU. Following TAR, speed, cadence and strides increased and mean total work approximated normal values. These two independent studies quantified the advantages of TAR over arthrodesis. Conclusion: This multioperator, multi-implant series of 592 patients confirmed literature data. Prospective follow-up of the cohorts managed in these expert centers is essential, in order to make available long-term data.
