Ankle Arthritis

By Courtney Laymon, PTA

Ankle Arthritis or Ankle Osteoarthritis (OA)

Ankle Arthritis or Ankle Osteoarthritis (OA) is the degeneration of joint articular surfaces including the cartilage and bones of the ankle joint. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful osteophytes (bone spurs). Inflammation, pain, swelling, and limited joint mobility are the result of OA.

Image of ankle with pain from Ankle Arthritis

Ankle Arthritis can cause pain in different parts of the ankle.

Osteoarthritis in the ankle, more specifically the tibiotalar and subtalar joints, is not as common as knee or hip joint arthritis. This is because of the inherent stability, bony congruity, large number of ligament support, and thicker articular cartilage that together protect against primary osteoarthritis (the breakdown of articular cartilage). Osteoarthritis of the ankle can lead to debilitating pain. This limits a person’s ability to walk long distances/duration and perform home/work activities. Many people with ankle arthritis rely on an assistive device, usually a cane. This is to decrease weight-bearing load on the affected limb.

To learn about Osteoarthritis of the knee read: How JOI Can Help Arthritis in The Knee

How Does Ankle Arthritis Occur?

Ankle osteoarthritis results from trauma to the ankle joint, primarily ankle fractures and secondarily to recurrent severe ankle sprains. Fractures cause damage to the chondral surfaces and can hasten the onset of progressive degeneration. Also, healed fractures can result in incongruent joint surfaces leading to overloading and further cartilage deterioration. Repetitive loading of the damaged tissue can result in severe pain, limited joint range of motion, crepitus (joint noise), and difficulty with walking. Symptoms typically worsen with prolonged walking and other vigorous activities.

Non-Surgical Treatment for Pain Around the Ankle Joint

Conservative management of ankle OA is something to try before referral for surgical consultation. Activity modification is a conservative measure and can include avoiding vigorous activities, restricting work-related movements that place high-impact stress on the ankle, and decreasing overall walking time often reduce the severity of symptoms and improve functioning in other activities. The use of external ankle supports (like the Arizona Brace) and assistive devices is also common practice to reduce load on the joint. Non-steroidal anti-inflammatory medications and intra-articular steroid injections can help treat inflammation. Physical therapy includes stretching, strengthening, joint mobilization, and gait training that can help reduce the progression of arthritis and improve function.

Ankle Exercise Videos

What If Conservative Management Doesn’t Work?

Sometime conservative management doesn’t help Ankle Arthritis. In such cases, surgical intervention is necessary for advanced ankle arthritis that significantly limits a person’s participation in daily function, home, and leisure activities. Surgical options vary in scope and effectiveness and include osteotomy, arthrodesis, and arthroplasty:

  • Osteotomies can be performed in early ankle arthritis to correct bony alignment deformities. The surgery consists of reshaping or realigning the bony structures within your ankle.
  • Arthrodesis refers to a surgical procedure that involves fusing the ankle joint into one bone. It is often performed when all other conservative treatments have failed in decreasing the patient’s pain. It is often necessary for end-stage ankle OA to allow for near-normal gait and pain.
Total Ankle Reconstruction

Ankle Replacement by JOI

  • Arthroplasty can also be called a total ankle replacement where the surgeon replaces the damaged parts of the ankle with either plastic or metal hardware. This is also another option for patients that are unable to get pain relief from other conservative options. An arthroplasty has shown to provide pain relief, improved gait, and patient satisfaction leading to a better quality of life when compared to an arthrodesis.

Related Articles: OsteoarthritisArthritis Overview Achilles Tendonitis Treatment

If your ankle is bothering you and after reading this you think you may be suffering from Ankle Arthritis or another ankle injury, JOI Can Help! Did you know you could try PT first before seeing an MD first? Book your PT appointment today by calling 904-858-7045. If you want to see an MD, we have Experienced Foot and Ankle Physicians which specialize in treating such injuries or ailments. To book an appointment with one today call 904-JOI-2000 or click the Book An Appointment button below!

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