Ankle Arthritis
Ankle arthritis is a condition characterized by inflammation and degeneration of the ankle joint. It usually happens when the protective cartilage that covers the ends of the bones in the ankle joint wears down over time, leading to friction, pain and stiffness. Ankle arthritis can significantly impact your ability to walk, stand and do your usual daily activities.
There are several types of arthritis that can affect the ankle joint, including:
Osteoarthritis: This is a very common type of arthritis and is caused by the gradual wear and tear of the joint cartilage over time. Osteoarthritis often develops as a result of aging, repetitive stress on the joint, previous injuries or underlying joint deformities.
Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, including the ankle. It occurs when the body's immune system mistakenly attacks the joint lining, leading to joint damage and swelling.
Post-traumatic arthritis: This type of arthritis develops following a severe ankle injury, such as a fracture, dislocation or ligament injury (ankle sprain). The injury can disrupt the normal joint mechanics and accelerate the breakdown of cartilage, leading to post-traumatic arthritis. This is likely a very under-recognised cause of ankle arthritis.
The common symptoms of ankle arthritis include:
Pain: Persistent pain in the ankle joint, which may worsen with activity or weight-bearing and improve with rest.
Stiffness: Reduced range of motion in the ankle, making it difficult to bend or move the joint fully.
Swelling: Inflammation and swelling around the ankle joint.
Instability: Feeling of instability or the ankle giving way.
Joint deformities: In advanced cases, the ankle joint may become mal-aligned or develop bony outgrowths (bone spurs).
Difficulty walking: Arthritis-related pain and stiffness can make it challenging to walk, causing a limp or altered gait.
The treatment options for ankle arthritis aim to alleviate pain, improve joint function and enhance overall quality of life. They can include both non-surgical and surgical approaches:
Non-surgical treatments include:
Activity and lifestyle modifications
Weight loss
Modified shoe-wear
Splints
Physiotherapy
Pain relief
Gait aids
Steroid or Hyaluronic injections
Surgical options include:
Corrective osteotomies - DTOO, SMO
Cheilectomy - Excision of bony spurs
Arthroscopic ankle debridement
Arthroscopic ankle fusion
Open ankle fusion
Total Ankle Replacement
The choice of treatment will depend on various factors including the severity of arthritis, the individual's age, medical problems, activity level and overall health.
Dr Janan has experience in all forms of treatment for ankle arthritis from minimally invasive procedures to Ankle Replacements. Together we will discuss your situation and determine which treatment will be the best choice for you.
FAQs
How can I differentiate between ankle arthritis and other conditions that cause ankle pain?
Differentiating between ankle arthritis and other conditions that cause ankle pain can be challenging as some symptoms may overlap. However, there are certain factors that can help distinguish between them. Other than characterising questions and findings on history and examination, imaging techniques such as CT and MRI scans can give us a clearer idea of what is causing the problems in your ankle.
Which operation is the most successful?
Together we choose a procedure which is most suited to you and this can be very different from person to person. However, the gold standard procedure for treating a severely painful and arthritic ankle is an Ankle Fusion. This involves removing all the residual damaged cartilage, removing the diseased bone and fixing both sides of the joint together with metalware.
Is an Ankle Replacement suitable for me?
The decision to have an ankle replacement is made on a case by case basis after thorough history, examination and imaging.
Generally it is considered if:
you are of an older age, low demand and reasonably mobile
you have good soft tissues in the area
you have a normal or low Body Mass Index (BMI)
have a good alignment of your foot and ankle
Reasons we think this operation should be avoided are if you have:
a very active lifestyle
an active infection
poor blood supply
bone loss in the area
nerve problems
a very deformed foot
How long am I off my feet?
Your ability to put weight through your foot after the operation depends on what type of operation you have. For minimally invasive operations you may be able to walk out of the hospital the same day. However, if you need a plaster then generally you are off your foot for 2 weeks and then walking in a special boot. We place importance on getting you back to life, and so we try to get you early functionality as long as it is safe to do so.