Ankle Arthritis

What is it?

Ankle arthritis is ‘wear and tear’ which leads to loss of the cartilage in the joint between the tibia, fibula and talus (ankle joint).  Cartilage is the lining on the bone ends which allows the joint to move smoothly and pain free. When this cartilage is damaged or lost the joint can become stiff and painful.

What causes it?

Osteoathritis may occur spontaneously with no history of injury.  Sometimes there is an injury or accident which can be recalled or multiple repeated injuries due to instability in the ankle joint.

There are other types of arthritis such as rheumatoid arthritis which can cause problems with multiple joints and the ankle can be affected.

What are the symptoms?

The predominant symptoms are pain and stiffness.  Crunching or clicking might be felt in the joint and there may be associated swelling.  As the symptoms progress the pain will become more constant affecting more and more activities and you may get pain at night.

How is it diagnosed?

A thorough history and examination will be performed and plain radiographs will be organised. Sometimes a CT scan may be necessary to assess the degree of damage and check the surrounding joints.

What are the treatments?

Conservative treatments include activity modification, pain killing tablets and bracing to support the joint.  If these measures fail and the pain interferes with daily activities you may have to consider surgery.

Ankle fusion has been the recommended treatment for ankle arthritis for many years and is a reliable pain relieving operation. As with all operations there are risks and complications and you will be advised about infection, non-union (bones not healing), nerve damage and blood clots (DVT).

Will I limp after a fusion?

Not usually. The other joints at the back of the foot and the joints in the midfoot remain mobile and walking on the flat is not a problem. Walking up hills usually requires you to turn the foot out slightly however most people with ankle arthritis do this anyway.

Can I have my ankle replaced?

Ankle replacements are becoming more reliable than in the past however we still don’t have as much information about their long-term performance as hip and knee replacements. If the ankle is too deformed then a replacement is not recommended.  The obvious advantage of a replacement is that movement is maintained and this can help to protect other nearby joints from increased wear and tear.