The 26 Review
- What is Ankle Arthritis Inflammation, pain, or stiffness of the ankle joints
- Causes Ankle arthritis occurs when the cartilage in the ankle joint breaks down
- Symptoms Swelling, stiffness or loss of mobility, deformity of the ankle, and pain
- Diagnosis Physical examination, X-rays, MRI, and CT Scans
- Treatment Bracing, cortisone injections, physical therapy, anti-inflammatory medications, and surgery (ankle fusion, total ankle joint replacement, bone spur removal)
Let’s take a closer look…
Arthritis is a disease that affects thousands of individuals each year and unfortunately, this disease is incredibly common within the ankles and feet. Although there is no cure for arthritis, there are a wide variety of treatment options available to slow the progression of the disease, as well as provide relief for symptoms. With proper treatment, many individuals are able to manage their pain, remain active, and lead fulfilling lives. There are three major types of arthritis that affect the foot and ankle, which include osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. The feet and ankles provide grave support, shock absorption, balance, and several other functions that are essential for standing, walking, running, and other daily occurrences. Three bones make up the ankle joint, allowing for up-and-down movement. There are 26 bones within the foot and more than 30 joints that enable a wide range of movement. These joints and bones are covered with articular cartilage, which helps the bones to glide smoothly over each other during movement. The synovium also produces a fluid that lubricates the cartilage to reduce friction. Arthritis occurs when there is a breakdown of cartilage within the ankle joint. As the cartilage breaks down it is more likely for the ligaments, joints, and cartilage to become damaged and inflamed. Because of this, the bones are able to rub together, making it painful to walk.
Ankle arthritis can occur from a variety of causes. Some of these causes include trauma (such as a car accident) or multiple ankle sprains, an autoimmune disease, or infection. In most individuals, ankle arthritis occurs due to the degeneration of the cartilage from either an old injury or general wear and tear over time.
The symptoms of arthritis typically vary depending on which joint or joints are being affected. In most cases, an arthritic joint will become painful and inflamed. Generally, pain will develop gradually over time, however sudden onset pain is also possible. Some other symptoms can include the following:
- Pain with motion
- Pain that flares up with increased or vigorous activity
- Joint swelling, warmth, and/or redness
- Stiffness or loss of mobility
- Tenderness when pressure is applied
- Deformity of the ankle
- Increased symptoms in the morning or after resting
- Difficulty walking due to the previously listed symptoms
If you or someone you know is experiencing any of the previously listed symptoms, it is highly advised to speak with a podiatrist.
When diagnosing ankle arthritis, there are a few things one can do. To begin, your podiatrist will gather a complete medical history, as well as ask about your overall health and any medications taken. They will then physically examine the foot and ankle for tenderness, swelling, and isolated pain. During this time, your podiatrist will also seek out any changes in skin and the presence or absence of nerve sensations. There may also be a gait analysis performed. The gait test observes the way one walks, in order to determine whether one’s pain and joint stiffness can be alleviated by changing how one walks. In addition, this test assesses how the bones in the leg and foot line up, measures one’s stride and tests the strength of the ankles and feet. Depending on the severity of a patient’s symptoms, an X-ray, CT scan or MRI may be ordered.
For ankle arthritis, there are a few non-surgical treatments, as well as a few surgical treatments. Non-surgical treatments include:
- Ankle bracing
- Cortisone injections
- Physical therapy
- Activity modifications
- Anti-inflammatory medications
If the non-surgical treatment options do not work on a patient, surgery can also be considered. There are four types of ankle arthritis surgeries provided, which include, ankle fusion, total ankle joint replacement, bone spur removal, and ankle arthroscopy. Ankle fusion or arthrodesis is a procedure that fuses the two bones, tibia and talus, that make up the ankle joint together, in order to make one solid block of bone. Fusion is great for relieving pain, however, all of an individual’s ankle motion will be lost. Total ankle joint replacement or arthroplasty is a replacement treatment that utilizes the newest implants available. This surgery is only appropriate for certain patients, but for the right individual, it can be highly successful in relieving pain and preserving function. Bone spur removal or debridement is only utilized in certain cases when one’s arthritis causes bone spurs to develop. The removal of these bone spurs can relieve pain and improve the range of motion within the ankle and foot. Lastly, ankle arthroscopy or an ankle scope is a minimally invasive procedure that can help flush out the joint of loose particles and inflamed tissue. This procedure is good for mild cases or early-stage ankle pain.