We’ve all heard of arthritis, an extremely common condition that many of us have in various joints of the body, from our hands to our hips to our knees, spine, and feet. But not many people know that arthritis is a general term that includes a group of more than 100 diseases. The most common form of arthritis that occurs in the ankle is osteoarthritis, which many people refer to simply as arthritis.
“Arthritis” means “joint inflammation.” Arthritis in the ankle joint can produce swelling and pain. Over time, ankle arthritis can eventually lead to deformity of the joint, loss of joint function, and decreased ability to walk.
What exactly is osteoarthritis? Osteoarthritis is a condition that affects the cartilage in the joint. Cartilage is normally a smooth connective tissue found at the end of bones that enables smooth movement between the ends of the two bones that make up a joint. The smooth surface allows for movement with minimal friction. But when the cartilage is damaged, the rough surface causes friction between the two ends of the bone, leading to inflammation and subsequent pain.
Other terms are also used to describe osteoarthritis. Osteoarthritis is also known as “degenerative arthritis” or a “wear and tear” disease. Both terms reflect the nature of this condition to develop as part of the aging process due to all the use the joint undergoes over time.
That leads us to the most common cause of osteoarthritis, which is repeated use over time. Repeated stress and use year after year causes the cartilage in the joint to wear down. As the cartilage deteriorates and gets thinner, the bones lose their protective covering and may rub together. For some people whose osteoarthritis is severe, the doctor might say that the cartilage has completely worn away and the patient’s case is “bone on bone.”
A second possible cause of ankle arthritis is a past injury, such as a broken bone or a severe sprain. It may take months or years after the injury for arthritis to develop.
People with ankle arthritis will experience one or more symptoms, in varying degrees. These symptoms include pain and stiffness in the ankle joint, swelling in or near the joint, and difficulty walking or bending the joint.
Many people need relief for these troubling symptoms and seek the care of a foot and ankle surgeon, a specialist who is trained to treat a wide variety of foot and ankle conditions, including ankle arthritis. Once this specialist thoroughly evaluates your condition, a treatment plan targeted to your specific needs can begin. Treatment can involve either non-surgical options or surgery.
Non-surgical—or conservative—treatment options may include taking oral medications, such as ibuprofen, to reduce the pain and swelling. Bracing may also be prescribed. Bracing serves the purpose of restricting motion and supporting the ankle joint. This can reduce the pain experienced when walking and can help prevent further deterioration. Another non-surgical option consists of steroid injections in the joint. These injections deliver anti-inflammatory medication directly to the affected area to reduce pain and inflammation.
If a patient’s osteoarthritis has progressed substantially or had failed to improve with conservative treatment, surgery may be recommended. In fact, in advanced cases, surgery may be the only option available to decrease pain and improve function. Depending on the patient’s medical condition, age, and other considerations, the surgeon will recommend one of two surgical options: either fusion (also called arthrodesis) or total ankle replacement surgery (also called ankle arthroplasty), which is fast becoming the procedure of choice for many people.
Fusion, or arthrodesis, is a procedure that has been used with success for many years to treat problematic cases of ankle arthritis. In this procedure, the joint is removed and the bones of the joint are fused together. This takes away the pain. However, it also makes the joint immobile. So there are benefits and drawbacks to this procedure.
Total ankle replacement is becoming increasingly popular due to breakthroughs in technology. Similar to knee and hip replacement surgery, ankle replacement surgery involves replacing the damaged joint with an artificial joint, or implant. Although total ankle replacement has been around for more than 30 years, recent advances have led to the availability of expanded choices of effective implants. Ankle replacement eliminates the pain of arthritis and also enables full movement of the joint. However, not everyone is a candidate for this procedure. Your foot and ankle surgeon will determine whether this procedure is right for you.
I hope this has given you some useful information about arthritis in the ankle. If you’re experiencing bothersome pain due to ankle arthritis, don’t despair. There are effective treatment options available to relieve your pain and help you function normally again.