Results at a minimum follow-up of 5 years of a ligaments-compatible total ankle replacement design

•No loosening 5 years after a ligament-compatible total ankle replacement.•Improvement of pain, ankle function and range of motion.•Overall survival rate of 97.3%. A new design of 3-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing certain fibers to remain isometric during passive motion. We evaluate 75 ankle prostheses implanted from July 2003 to December 2008, at a mean follow-up 6.5±1.1years (range 5–9 years). The mean age at surgery was 62±13years (range 29–82). The mean AOFAS scores achieved at pre-op and at last follow-up were respectively 37±5 (23–45) and 78±8 (64–98). (p