Ankle Arthritis

Joints such as the ankle have specialised articular (joint) cartilage and a small amount of lubricating joint fluid kept within the joint by a joint capsule. The capsule stops the fluid from leaking out. If the cartilage is damaged for any reason, this may lead to arthritis. This usually results in pain, swelling and stiffness of the joint involved. It can occur in any age group but is most common in the middle to older age groups and depends on the underlying cause. There is no cure for arthritis but there are many ways to help relieve symptoms. If managed effectively, people with arthritis may live healthy, active lifestyles with or without surgery.

  • Video:

    This surgical procedure is performed to treat severe arthritis or injury of the ankle joint. During the procedure, the surgeon removes damaged bone and cartilage and fuses the joint. This stabilizes the ankle and relieves pain.

    This procedure identifies and treats problems in your ankle. With it, the surgeon can access your ankle without creating a large incision.

  • Cause:

    In the ankle it is most commonly due to post-traumatic arthritis:

    • Ankle fracture +/- dislocation
    • Articular cartilage damage
    • Chronic ankle instability

    Other causes may be related to inflammatory arthropathy; most commonly rheumatoid arthritis, primary osteoarthritis which is relatively uncommon, and other causes such as septic arthritis (infected joint), Charcot arthropathy or haemochromatosis.

  • Symptoms:

    Usually involve pain, especially with activity and particularly first thing in the morning, progressive stiffness, swelling and clicking or catching.

  • Natural History

    Usually gradually but sometimes more rapidly gets worse.

  • Imaging

    Weight-bearing X-rays are required.
    Long leg X-rays, CT scans or MRI scans may be required.

  • Non Operative Treatment:
    • Topical pain creams e.g. NSAIDS
    • Pain medications e.g. NSAIDS such as Mobic or Panadol Osteo
    • Lace up ankle brace
    • Shoe wear modification: lace up ankle boots, stiffer-soled shoe with rocker bottom modification
    • Activity modification: improve fitness and strength via non axial loading exercises e.g. cycling,
      swimming. Avoid axial loading exercises e.g. running
    • Weight loss management
    • Joint injections
    • Occasionally viscosupplementation may help
  • Surgery:
    Considered if symptoms are progressing and function is decreasing after a trial of non-surgical treatment.
    Depending on the extent of disease, surgical options may include:

    • Arthroscopic procedures: if bony impingement is contributing or causing symptoms and
      oateoarthrits is not widespread throughout the joint
    • Bone realignment osteotomy: if osteoarthritis is focal then shifting the bone alignment may help decompress the painful area
    • Ankle fusion: open or arthroscopic – if osteoarthritis is advanced and the patient suffers significant symptoms on a daily basis. More suited for younger, more active patients and those who work in
      manual labouring positions
    • Total ankle replacement: many factors are used to determine if a patient is suitable for joint replacement. This includes if osteoarthritis is advanced and the patient suffers significant symptoms on a daily basis. It is more suitable for older people who are not in manual labourer positions and whose activity can be restricted to lighter weight activities

    Please find more information in the post operative protocol section for your specific surgical procedure

Post Operative Guide Further Reading

General info: