Ankle Arthritis

Ankle arthritis is loss of the ankle joint’s cartilage lining. The most common cause is previous trauma, but in some patients it may occur due to inflammatory conditions such as rheumatoid arthritis.

The loss of cartilage causes narrowing of the ankle joint space and bony spurs (osteophytes) develop. The ankle becomes painful, stiff, and may ‘grind’ or lock. This also causes inflammation of the lining of the joint, and swelling. Symptoms range from pain with walking, stiffness and decreased function to swelling, throbbing and pain at night. 

NON-OPERATIVE MANAGEMENT

These include losing weight, using walking aids such as a walking stick, and avoiding impact activities such as jumping and running. Low impact activities such as cycling, swimming, and walking are recommended.

Shoe inserts and shoes such as Joggers with a rocker-bottom sole may help. Ankle bracing or a custom fitted splint can be useful. Simple paracetamol and anti-inflammatory medications if tolerated are useful adjuncts.

Cortisone injections act to decrease inflammation and can be useful for temporary relief.

Platelet Rich Plasma (PRP) injections utilise the individuals own chemical mediators harvested from a blood sample. These also act to decrease inflammation and pain. There is currently little evidence PRP reverses osteoarthritis.

The degree and extent of relief varies from patient to patient for both cortisone and PRP.

OPERATIVE MANAGEMENT

When non-operative measures fail, there are 3 main surgical options. These are Ankle Arthroscopy, Ankle fusion and Total Ankle Replacement. The best option for an individual patient depends upon many factors including the severity of arthritis, the age and functional demands, and the presence of arthritis in other joints. The ultimate choice is a combined decision between surgeon and patient.

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