Ankle Arthritis

Ankle arthritis affects many people for a variety of reasons. It is defined as a loss of the cartilage between the tibia and talus. Most commonly, the cause is post-traumatic such as after an ankle fracture or due to chronic sprains. Occasionally it occurs for no obvious reason.

Diagnosis

Arthritis of the ankle occurs in the tibiotalar joint or the joint that allows your ankle to move up and down. Symptoms may start with soreness after prolonged activity and then progress to pain with any upward motion of the ankle. Some people with have a progressive deformity of the ankle due to the breakdown of the joint.

Weight bearing x-rays are usually all that is needed to confirm the diagnosis. Occasionally, a CT scan will be used to evaluate the other joints around the ankle to determine if treatment is required for those joints as well.

Treatment

• Non-operative

  There are many non-operative treatments for ankle arthritis that can keep people functional and painfree for many years before anything surgical needs to be done. These treatments include bracing, physical therapy, injections and shoe inserts. These treatments are individually recommended depending on the extent of the arthritis and the factors contributing to it.

• Operative

  Surgery can be very helpful for people with arthritis of the ankle and is divided into 3 types.

  • Debridement: many people have symptoms from bone spurs in the front of the ankle that impinge with motion. These spurs can be removed arthroscopically or through minimally invasive incisions and provide patients with significant relief for a prolonged period of time.

  • Fusion or Arthrodesis: this is the most reliable surgical treatment for permanent relief of ankle arthritis. Despite the loss of motion that occurs with the surgery, the relief of pain is dramatic and most patients actually walk better because they no longer have pain.

  • Ankle replacement: this is an increasingly common procedure for treatment of ankle arthritis. The technology has dramatically improved over the past several years and the materials used can provided excellent pain relief with preserved motion for the right patient. These procedures should only be performed by orthopedic surgeons with advanced training in foot and ankle surgery such as Dr. Mihalich.