Abstract: Current total ankle replacements suffer from unacceptable rates of failures. This team believes that a key reason is their improper surface design, which produces incorrect and unnatural kinematic characteristics. All present TARs were designed with articulating surfaces that were either cylindrical or represent the surface of a truncated cone with its apex oriented medially. Recent studies by this team have identified and proven the incorrectness of these concepts by identifying the surface morphology to be that of a skewed truncated saddle-shape cone with its apex oriented laterally rather than medially. The International Biomechanics Community recognized the importance of this recent discovery by selecting this work for the prestigious Clinical Biomechanics Award from the International Society of Biomechanics (ISB). Currently, a team from Drexel University and Istituto Ortopedico Rizzoli is conducting studies in order to develop and evaluate a TAR prototype based on the newly discovered concepts.