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Ankle Arthritis


There are three main types of arthritis affecting the ankle joint
Post-traumatic Arthritis: This is the most common cause of Ankle arthritis. This develops following an ankle fracture, dislocation or any type of injury affecting the normal shape and position of the joint. This causes abnormal mechanics to pass through the joint leading to early wear of the cartilage (the fine lining covering the end of the bone where it joints to a different bone).
Osteoarthritis: Also, called degenerative joint disease, occurs most often in older people. The cartilage wears away with time leading to pain, inflammation and stiffness. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in the joint, causing bone-on-bone contact. The edges of the end of the tibia (shinbone) or talus (ankle bone) may become more prominent and stick out at the end of the joint, this is called an osteophyte or bone spur.


Rheumatoid arthritis: This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infections) attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, and loss of function in joints. Rheumatoid arthritis affects mostly small joints of the foot and tends to be bilateral.
Other less common causes of Ankle arthritis are osteonecrosis, neuropathic arthritis, septic arthritis (joint infection), gout and Haemophilia.
Symptoms of ankle arthritis include pain or tenderness at the front of the ankle, swelling, stiffness in the joint and limited range of motion. The latter is mostly noticeable when walking up or downhill, or when trying to perform a leg squat.
The diagnosis is made with a medical history, physical examination and X-rays of the affected joint. A bone scan, computed tomography (CT) scans with or without contrast and magnetic resonance imaging (MRI) scans are also performed to diagnose arthritis.
The initial treatment consists of non-surgical options with lifestyle modifications, analgesics, orthotics, weight loss, physiotherapy and braces to support the joint. If this fails, an injection in the joint may be proposed to mitigate the pain. However, this is offered case by case depending on the severity of the symptoms and the images.
Surgery may be required to treat ankle arthritis if your symptoms do not improve with conservative measures. Options are ankle arthroscopy, ankle fusion (locking the shinbone and the ankle bone) or ankle replacement (replacing the bottom and top parts of the joint with an artificial implant).