Preclinical biomechanical testing models for the tibiotalar joint and its replacements: A systematic review

•Cadaver models have used a large variety of methods and a large range of loading to study ankle joint kinematics.•Ankle joint simulations to measure polyethylene wear have used appropriate loads, i.e., 4–5 times bodyweight.•Studies of natural or artificial ankle joint kinematics, fixation or stability have all used loads well below bodyweight.•Compared to other joint replacements, there is a major lack of preclinical testing for total ankle replacements.