Total Ankle Arthroplasty in France : Current Indications and Future Perspectives
Seance of wednesday 22 october 2025 (L'Académie reçoit l'Association Française de la Chirurgie du Pied (AFCP))
DOI number : 10.26299/b5qd-zd75/emem.2025.43.01
Abstract
Total ankle arthroplasty (TAA) is now a credible alternative to arthrodesis in the treatment of ankle osteoarthritis. In France, its use remains limited, with approximately 600 procedures performed each year, far behind other arthroplasties such as hip replacement.
The history of ankle prostheses has been marked by several generations of implants, with progressive improvements in survival rates, now exceeding 90% at ten years in recent series and national registries. Currently, the practice is concentrated in a few expert centers, hindered by insufficient reimbursement and the lack of funding for revision procedures.
Recent innovations, such as 3D planning leading to the manufacture of patient-specific instrumentation (PSI), represent major advances that enhance surgical safety and broaden indications. Clinical outcomes demonstrate efficacy comparable to, and in some studies even superior to, arthrodesis, particularly in terms of function and quality of life, although the learning curve remains a key factor.
In conclusion, total ankle arthroplasty is a validated, effective, and constantly evolving technique. Its future will depend on stronger structural support, including adjusted reimbursement, enhanced training, and optimal use of registries, in order to fully realize the potential of promising innovations already available.
The history of ankle prostheses has been marked by several generations of implants, with progressive improvements in survival rates, now exceeding 90% at ten years in recent series and national registries. Currently, the practice is concentrated in a few expert centers, hindered by insufficient reimbursement and the lack of funding for revision procedures.
Recent innovations, such as 3D planning leading to the manufacture of patient-specific instrumentation (PSI), represent major advances that enhance surgical safety and broaden indications. Clinical outcomes demonstrate efficacy comparable to, and in some studies even superior to, arthrodesis, particularly in terms of function and quality of life, although the learning curve remains a key factor.
In conclusion, total ankle arthroplasty is a validated, effective, and constantly evolving technique. Its future will depend on stronger structural support, including adjusted reimbursement, enhanced training, and optimal use of registries, in order to fully realize the potential of promising innovations already available.