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.

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

• Basic Ankle Exercise
• Ankle Resistance Band Exercises

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.

• 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.

Total Ankle Replacement Surgery by Dr. Carrasquillo

Dr. Carrasquillo is a doctor at The Jacksonville Orthopaedic Institute’s San Marco location. He specializes in the treatment of the foot & ankle, lower leg and general orthopedic surgery. This is a testimonial from one of his former total ankle replacement patients.

“Dr. Hiram Carrasquillo has given me my life back! He is a talented individual who is everything you want in a doctor and surgeon. He treated me with respect, was very professional and showed concern for my well-being and future health. Dr. Carrasquillo took the time to not only diagnose and treat my ankle but also provided me with realistic expectations about my surgery and recovery. I was apprehensive about ankle arthroplasty however this skillful surgeon truly performed a miracle. Now I am less than three months post-op and am walking without difficulty. I would recommend anyone that is looking for a phenomenal orthopedist to see Doctor Carrasquillo at JOI.”

-Ellen Lowe

Related Articles: 

• Osteoarthritis
• Arthritis Overview
• Achilles Tendonitis Treatment

Book an Appointment with The Jacksonville Orthopaedic Institute Today!

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!

New to JOI, you can now make and cancel physician follow-up visits on the JOI Patient Portal.