Arthritis of the Ankle

Article featured on University of Michigan Health

Ankle arthritis occurs when there is a breakdown of cartilage in the ankle joint.  It can result from a variety of causes, including trauma (such as a car accident), autoimmune diseases (such as rheumatoid arthritis) or infection. In most cases, ankle arthritis is due to the degeneration of the cartilage from an old injury.

If you have – or suspect you have – ankle arthritis, we can provide you with a complete diagnosis and a personalized treatment plan. Experience is crucial in treating ankle arthritis, and we see many patients with complicated foot and ankle conditions.

Ankle Arthritis Symptoms

• Pain that may increase with activity
• Stiffness or loss of mobility
• Swelling
• Deformity of the ankle

Ankle Arthritis Diagnosis

So we can understand your condition, during your office visit:

• We will take a complete history and conduct a physical examination to assess skin changes, the presence or absence of pulses and nerve sensations, the range of motion in your ankle, and the areas of discomfort.
• We will take X-rays to evaluate your degree of arthritis and any associated ankle problem.
• We may order further testing, such as a CT scan or MRI if we are considering surgery as an option.

Ankle Arthritis Treatments

Your individualized treatment plan is based on any previous treatments you have had, your current level of disability,  the presence of other medical conditions, and our findings from your health history, exam and X-rays.

Non-Surgical Treatments

We always look at non-surgical treatments first, especially if you have never received any other treatments. Treatments can include:

• Ankle bracing – Either a custom-made or pre-fabricated ankle brace will stabilize your ankle joint and provide support for your ankle.
• Cortisone injections – Cortisone injected into the ankle can reduce pain and swelling during a flare-up.
• Activity modifications – Limiting high-impact activities, such as running, jumping or court sports, or switching out high-impact activities for low-impact options may be an option for you.
• Ice and anti-inflammatory medications – We may give you these as needed to decrease symptoms.

Surgery

Surgery is only considered if all appropriate non-surgery treatments have failed. The types of surgeries we do include:

• Ankle fusion (arthrodesis) – This procedure can be done either inpatient or outpatient, depending on your condition. Ankle fusion fuses together the two bones that make up the ankle joint – the tibia and talus – to make one solid block of bone. Fusion is an excellent pain-reliving procedure for arthritic joints. It involves removing the cartilage from a joint so it grows into one bone, eliminating the pain of bones rubbing against each other. Fusion of the ankle does result in loss of approximately 75% of ankle motion, but some motion is kept through the joints underneath the ankle and into the mid-foot.
• Total ankle joint replacement (arthroplasty) – This ankle joint replacement treatment utilizes the newest implants (prosthesis) available. The surgery is only appropriate for certain patients with ankle arthritis, but for the right candidate, it can be very successful in preserving function and providing excellent pain relief. We are one of the few health care providers to offer total ankle replacement to our patients, and our surgeons are highly experienced in this procedure.
• Bone spur removal (debridement) – Arthritis can cause bone spurs to develop on the ankle joint, and removal of these bone spurs, either through an open ankle incision or through an ankle scope (arthroscopy), may relieve pain and improve range of motion.
• Distraction arthroplasty – This is a new joint restoration technique that uses an external frame (applied surgically) placed around the outside of the leg to spread the surfaces of the ankle joint, to encourage new cartilage growth. This procedure maintains ankle motion and relieves pain.

Our surgeons will be happy to discuss the pros and cons of surgery, and to let you know if they think surgery is the best option for you.