Total ankle arthroplasty in younger patients: Current concepts, contemporary evidence, and decision-making considerations

Abstract

This article reviews the current evidence on total ankle arthroplasty (TAA) in patients younger than 55 years, including recent clinical outcomes and technical considerations, through a comparative analysis that underscores the areas of greatest controversy in its application. It is highlighted that, although in this group of patients there are higher rates of revision and re-operation, compared to older patients, the current evidence of TAA with state-of-the-art implants shows an acceptable survival in the medium term even in cohorts with young patients, indicating that, although age may be a risk modifier, it is not in itself an absolute contraindication. Rigorous patient selection and precise alignment are determinants, while prosthetic design and proper deformity correction significantly influence outcomes. Level of Evidence V; Narrative Review, Expert Opinion