Ankle arthritis is a degenerative condition also known as osteoarthritis. It can cause pain, stiffness, and disability of the ankles. The protective cartilage in the ankle begins to wear away over time, eventually causing the bones in the ankle to rub against each other. Ankle arthritis can be just as disabling as hip arthritis, but it is not as well-known as other types of arthritis.
Ankle arthritis tends to affect a younger population because it often develops after an ankle injury like a fracture. Conditions like flat feet and even repetitive ankle sprains can also lead to degeneration of the ankle joints over time.
At Summit Orthopaedics, our foot and ankle surgeons offer a number of treatment options for ankle arthritis.
Symptoms of Ankle Arthritis
Symptoms of ankle arthritis are often gradual, developing over time. Pain is one of the most common symptoms. Patients with arthritis may feel pain with motion, or after an extended period of rest or physical activity.
Other symptoms include tenderness, swelling, and stiffness of the ankle joint. These symptoms can make it difficult to walk, and may eventually lead to significant disability. Proper treatment can help manage these symptoms.
Risk Factors Associated with Ankle Arthritis
The risk factors associated with ankle arthritis include age, obesity, and family history of the disease.
Diagnosing Ankle Arthritis
Your foot and ankle doctor will ask you questions about your medical history and any medications you may be taking, examine your ankle for tenderness and swelling and ask you specific questions about the pain you are experiencing, such as
- Where exactly is the pain?
- When did the pain start?
- Is the pain continuous or does it come and go?
- Does the pain feel worse in the morning or at night?
- Does the pain get worse with activity, such as when walking or running?
You will also be asked to describe your injury, including when it occurred, and if you had received any prior treatment.
Your doctor will also observe your gait (the way you walk) during your physical examination. This is an important assessment, as pain and joint stiffness from arthritis change the way you walk. A gait analysis helps your doctor assess how the bones in your leg and foot line up when you walk, measure your stride, and test the strength of your ankles and feet.
Additionally, your doctor will examine your shoes to determine if there is any abnormal or uneven wear to ensure that they are providing sufficient support for your foot and ankle.
The primary purpose of shoes is to protect your feet and prevent injury. Poorly fitted shoes can cause discomfort, injury, and permanent deformity. Understanding the components of a shoe and the proper fit can help you make sensible shoe purchases. The most important quality to look for in shoes is durable construction and a good fit.
Imaging tests help your foot and ankle doctor determine the severity of your arthritis.
X-rays provide detailed images of your bones, as well as any narrowing of the joint space between bones (an indication of cartilage loss), fractures, and the formation of bone spurs.
Other imaging tests, such as a bone scan, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) may be ordered to determine the condition of the bone and soft tissues.
Treatment for Ankle Arthritis
There is no cure for ankle arthritis, but the right treatments can alleviate your symptoms. At Summit Orthopaedics, we offer both nonsurgical and surgical treatment options to help you remain active and reduce or eliminate arthritis pain.
Nonsurgical treatment typically includes anti-inflammatory medications, activity modification, corticosteroid injections, topical anti-inflammatories, physical therapy, and bracing.
If your doctor recommends physical therapy, it is important that you follow through with this recommendation and get the therapy prescribed.
If nonsurgical treatment does not adequately address the pain caused by ankle arthritis, surgical treatment options may be considered.
Traditionally, surgical treatment for ankle arthritis has involved ankle arthrodesis, also known as ankle fusion. In this procedure, the damaged bone and cartilage in the ankle are removed, and the joint is held together with fixation devices like plates and screws so that the bones fuse together. However, this procedure eliminates the range of motion in the ankle, which can put stress on other joints to compensate for the lack of motion in the ankle.
At Summit Orthopaedics, our orthopedic surgeons offer the latest developments in ankle arthritis surgery that allow the ankle to retain a range of motion while also relieving pain.
Recovery from Ankle Arthritis Surgery
Patients who undergo ankle arthritis surgery can expect to return to daily activities in 3 to 4 months and can expect a full recovery within 4 to 9 months.
After surgery, you can expect to have a cast applied to limit movement in your foot and ankle. You will also be advised to elevate your foot above the level of your heart for 1 to 2 weeks after surgery. Pain medication will be prescribed for a short time while you are home.
Additionally, your doctor may recommend physical therapy to help you regain strength in your foot and ankle and to restore range of motion.
Most causes of ankle arthritis are caused by damaged cartilage from a previous injury. However, arthritis can also affect the ankles due to rheumatoid arthritis, autoimmune disease, or an infection such as Staphylococcus aureus.
While the exact cause can influence the onset of symptoms and progression of the disease, the most important thing to focus on when living with ankle arthritis is finding appropriate treatment. The underlying cause can influence which treatments are ideal for a patient, but they may also change over time as symptoms evolve and a patient’s needs change.
Any high-impact exercise, such as running or jumping, is best avoided to prevent additional strain on the ankle joints. Most sports, like basketball or soccer, are also not recommended. Instead, patients will benefit from choosing low-impact movements that are gentle on their ankles. Swimming can be especially beneficial for those with ankle arthritis as the natural buoyancy of water takes pressure and tension off of the joint.
If you practice yoga or stretching, avoid poses that overextend the calf muscles or require placing body weight too much on the ankles, as this can lead to more pain.
Ankle arthritis is one of the slower progressing types of arthritis, often taking several years to advance to a severe stage. The amount of time it takes for the condition to progress will depend on when it is detected; early diagnosis can lead to more effective interventions that significantly delay the onset of worse symptoms.
Those diagnosed at grade 3 will need more advanced interventions to slow down their progression to grade 4, such as ankle replacement or ankle distraction arthroplasty.
Grade 4, or bone-on-bone arthritis, means there is no longer any protective cartilage covering the joint. This leads to immense pain, inflammation, and difficulty moving. As a severe form of osteoarthritis, bone-on-bone ankle arthritis requires a combination of personalized treatments to help a patient alleviate pain and restore as much mobility as possible.
Potential non-surgical treatment options include hot and cold therapy, pain medication, and low-impact exercise. Some patients also find that using a supportive device diminishes some of their discomfort.
Surgical interventions may include a total joint replacement, or arthroplasty, to replace the damaged joint with a synthetic one made from a durable material like ceramic or metal.
Some patients can benefit from wearing ankle braces, but it is not recommended to wear them unless you have been instructed to do so by a doctor. Using unprescribed ankle braces may induce compression that worsens pain and symptoms.
If you would like to explore ankle braces for managing ankle arthritis pain, then please reach out to us to schedule an appointment. We can recommend the best type of ankle braces for you based on your arthritis stage and current symptoms.
Ankle Arthritis Treatment in Portland, Oregon
Our foot and ankle surgeons at Summit Orthopaedics offer a full range of nonsurgical and surgical treatments for ankle arthritis. If you would like to schedule an appointment, please call our office at 503-850-9940.