Just like the knee or hip, arthritis can exist in the ankle.
Ankle arthritis usually results from some type of injury in the past,
like a fracture or severe sprain. It is rare for arthritis to occur
spontaneously in the ankle, unless there is a history of some type of
inflammatory arthritis (i.e. rheumatoid arthritis).
Some typical symptoms may include pain and swelling, especially worse with activity or prolonged walking.
Some of the ways we treat ankle arthritis are with non-steroidal anti-inflammatory drugs (NSAIDs),
various types of braces, and
activity modification. Cortisone injections are also commonly used.
Unfortunately, we can never get rid of arthritis. The above mentioned treatment options
attempt to keep the pain down to a manageable level. If they do not provide a reasonable
amount of relief, then surgery may be indicated.
Arthroscopy of the ankle attempts to debride the joint.
However, it does not change or remove the existing arthritis.
Any pain relief from this surgery is usually temporary at best.
The length of pain relief, if any, varies greatly.
This surgery is best indicated for younger patients who are trying to avoid the
bigger surgeries I will discuss below.
Ankle fusion is the most common surgery to treat arthritis.
It is considered the gold standard.
The ankle joint is formed primarily by the tibia and talus.
It is the motion between these bones along with there arthritic surfaces that causes pain.
Fusion surgery attempts to eliminate this motion by essentially turning these two bones into one.
During this surgery we prepare the joints to make the body think there is a fracture.
We hold these bones together using metal screws and/or plates.
We then wait for the body to bring new healing bone across this joint to eliminate
any possible motion. This process usually takes at least 6-8 weeks in most patients.
The third option is an ankle replacement. The obvious advantage of this procedure over a
fusion is the preservation of ankle motion. However, an ankle replacement should in no
way be compared to a knee replacement, which is one of the most successful operations in
orthopedic surgery. The prostheses for this operation have undergone quite an evolution
over the years. Some older implants have been removed from the market by the FDA due
to concerns of loosening of the implants. The newer implants have most definitely
improved upon the faults of previous products. However concerns about
the longevity of these implants still exist, and there are no long-term studies to
demonstrate longevity of the procedure.