Complete Guide on Ankle Arthritis

What is Ankle Arthritis?

Ankle arthritis is a degenerative joint condition where the cartilage is damaged or wears thin at the ankle joint, which comprises two bones, the talus and the tibia, mainly with a further articulation around the fibula bone distally. The progressive condition causes gradual wear and tear of the joint with either holes within the cartilage or thinning of the cartilage leading to bone on bone contact.

Causes of Ankle Arthritis

The cause of ankle arthritis can be varied but most likely are either genetic or after trauma.

People who play sports often have inversion sprains and various other ankle injuries that develop an increasing amount of use and wear and tear over time resulting in arthritis. Other rare conditions include avascular necrosis where there’s death of the bone or infections that lead to secondary arthritis.

Symptoms of Ankle Arthritis

The symptoms initially can be stiffness in the joint with little or no pain. You can sometimes have catching or clicking of the joint or pain deep in the joint in certain positions. There could be instability also where you feel that the ankle does not feel right or pain when weight bearing.

Diagnostic methods for Ankle Arthritis

X-rays can show loss of cartilage and bony outgrowths known as osteophytes, as well as changes in the bone texture known as subchondral sclerosis.

CT and MRI scans are used in terms of advanced imaging.

MRI has an advantage in that it can also assess the soft tissues around the joint and the level of inflammation.

CT provides a more three-dimensional view of the ankle itself and helps in treatment planning.

Treatment options very much depend on the stage of the arthritis in the ankle. Initially you may try bracing or stability shoes such as high ankle boots. Otherwise injections such as steroid, hyaluronic acid or prolotherapy which could reduce some of the inflammatory components and provide some lubrication to the joint.

Surgical treatment of ankle arthritis depends on the degree of symptoms and progression deformity and may be from arthroscopic keyhole surgery to cleaning up the joint or a fusion or a replacement of the ankle joint.

Non-surgical treatments are orthotics, ankle braces, injections and physiotherapy and rehabilitation of the ankle to strengthen it.

Surgical Treatments

Arthroscopic treatment of the ankle involves using a small camera and shavers to reduce some of the inflammatory tissue and to encourage fibrocartilage growth by performing osteochondral lesion treatment.

Sometimes an ankle fusion is needed which has a long history of resolving problems. It does stiffen your ankle but provides pain-free movement in the limb. It can be done either arthroscopically or open.

Ankle replacements require a special registry as they are relatively new. They allow continued movement in the ankle joint whilst resolving the symptoms.

After Care and Recovery

After care and recovery following surgery depends on the procedure. A fusion may require you to be in a cast for six to eight weeks, whereas ankle arthroscopy where you’re just cleaning out some tissues allows early mobilisation. Ankle replacement takes a couple of weeks of rest followed by physiotherapy and mobilisation.

Frequently asked questions

Q. Can ankle arthritis be cured?

A. Ankle arthritis is not reversible, but it can be slowed down by treatment, bracing and injections. It can be cured in terms of the symptoms, which can be managed with either ankle replacement or fusion.

Q. Is surgery always necessary for ankle arthritis?

A. Surgery is the last stage of treatment, we would always try to use non-surgical methods such as injections and bracing in the first instance.

Q. How can I prevent ankle arthritis?

A. You have to be unlucky to develop ankle arthritis. In terms of prevention, maintaining a healthy weight and diet can reduce the risks. Regular exercises could help.

Q. Are there any specific exercises recommended?

A. Stretching soft tissues and strengthening the ankle musculature can provide greater stability.

Q. How long does it take after ankle surgery to recover?

A. Recovery depends on the type of procedure and can vary from two weeks to three months.