Functional Outcome of Total Ankle Arthroplasty in Patients Under and Over 50 Years of Age

End-stage ankle osteoarthritis is a debilitating condition that significantly impacts patient function and quality of life. Total ankle arthroplasty (TAA) has emerged as an alternative to arthrodesis, offering pain relief while preserving joint mobility. However, its outcomes in younger patients remain controversial due to concerns regarding implant survival and revision rates. This study evaluates the functional outcomes of TAA in patients ≤50 years compared with those >50 years. A retrospective cohort of 32 patients was analyzed, with functional assessment based on the Visual Analog Scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot Function Index (FFI). The median follow-up period was 4.1 years in the younger cohort and 4.4 years in the older cohort. Both groups demonstrated statistically significant postoperative improvements in pain and function ( P <0.05). Prosthesis revision was more frequent in patients ≤50 years, whereas all forms of reoperations were more common in those >50 years. Despite differences in complication profiles, overall functional outcomes were comparable. These findings support TAA as a viable surgical option across age groups, with younger patients demonstrating satisfactory functional results despite a higher revision rate. Adequate patient selection and long-term surveillance remain critical for optimizing outcomes. Level of Evidence: Level 3.