What is ankle arthritis?

Arthritis of the ankle joint causes stiffness and pain and may affect the way you walk.

What causes ankle arthritis?

Arthritis is caused when the cartilage (the soft smooth shiny surface) of joints wears out. It is often related to a previous ankle injury such as a sprain or fracture. This problem will likely get worse over time and can cause the ankle to tip over.

What problems does it cause?

This causes pain deep inside the joint as the bone ends rub together without their shiny smooth surfaces. When it gets bad enough the pain may be there all the time, even at rest and at night. Arthritis also causes the joint to grow bony bumps around the edges (osteophytes), which can stop the joint moving and it becomes stiff.

Non-surgical treatment:

It is important you are assessed by a specialist to diagnose the problem properly and design the treatment to suit your specific problem and needs.

Weight loss, painkillers and supportive footwear such as lace-up boots that go above the ankle can help in the early stages.

Steroid injections into the ankle joint can give temporary pain relief.

Surgery:

Surgery depends on your lifestyle and how bad the arthritis is. There are several operations available. Some operations aim to get the joint moving better, the other options aim to treat the pain.

 

Keyhole surgery: In early arthritis keyhole surgery may help to treat pain and stiffness. This involves making 2 very small cuts on the front of the ankle to put a camera and a shaving tool into the ankle to clear out the joint, allowing it to move more.

After keyhole surgery

After keyhole surgery you should be comfortable and nearly all patients go home on the same day. You will have a bandage on your ankle and may be in a boot and using crutches for the first 1-2 weeks.

For the first 2 weeks you will need to keep your foot elevated above your heart at home to keep the swelling down. This is extremely important as it reduces pain, reduces the risk of infection and allows the wound to heal.

Ankle replacement: Some patients may be candidates for an ankle replacement. The aim of this surgery is to replace the joint with an artificial one that is made from highly specialised metal (cobalt-chromium-molybdenum alloy and titanium) and plastic (polyethylene). This allows the ankle to keep moving without pain, allowing a more natural movement in the foot, which reduces the rates of arthritis occurring in the surrounding joints.

After ankle replacement

After ankle replacement you will need to stay in hospital for 1-2 nights to keep you comfortable. You will be in a plaster cast and will be keeping your weight off the foot for 2 weeks.

It is likely you will need to have blood-thinning injections for 2 weeks to prevent a blood clot in the leg.

At 2 weeks your cast will be removed and the stitches will be taken out.

Then you will be placed into a boot for 4 weeks and allowed to walk on the foot.

Ankle fusion: This method removes the joint surfaces and permanently fuses the 2 bones together. This is done with the foot in the correct position to allow you to walk. This operation is very good at improving the pain. There are often concerns that you won’t be able to walk properly after a fusion but most patients walk extremely well in normal footwear. There are many joints in the foot allowing motion even after the ankle is fused. It can lead to arthritis in other joints in the future but is still a good option in some patients.

After ankle fusion

After ankle fusion you will need to stay in hospital for 1-2 nights to keep you comfortable. You will be in a plaster cast and will be keeping your weight off the foot using crutches or a frame for 6 weeks.

It is likely you will need to have blood-thinning injections for 6 weeks to prevent a blood clot in the leg.

At 2 weeks the cast will be changed and the stitches will be taken out.

Then you will be placed back into a cast for another 4 weeks.

After this the cast will be removed and you will be placed into a boot for 6 weeks and allowed to walk on the foot. Once the bones have healed together the boot can be removed.

 

It is crucial you don’t smoke (including e-cigarettes) or take anti-inflammatories for at least 8 weeks after the surgery.

What is ankle arthritis?

This website is designed and run by Mr Edward Gee, a Consultant Orthopaedic Surgeon specialising in Foot and Ankle Surgery, as an educational resource for Patients and Professionals.

View More Videos

Foot and Ankle Expert FAQs

    Osteoarthritis is commonly referred to as “wear and tear” as this occurs when your ankle joint cartilage wears away over time. It can be related to your genes, activities or a previous injury.

    Ankle osteoarthritis often causes an aching pain deep inside your ankle joint. Your pain may be worse during or after activity and in the evening to begin with. Eventually it can become painful even when you are resting or during the night, disturbing your sleep.

    As a foot and ankle specialist, I will be able to assess the condition of your ankle by taking a detailed and personalised history and examining your ankle. X-rays and an MRI scan will give more information about the amount of arthritis you have in your ankle and help me to decide on the best treatment options for you.

    Your treatment is tailored to you and is based on your symptoms, the stage of arthritis in your ankle and your lifestyle. Early treatment may involve techniques to reduce the forces going through your ankle and reduce your pain. Steroid injections can give short or medium-term pain relief. Surgery may be offered if your symptoms are bad enough with a variety of options available. If your ankle contains a small area of arthritis, then keyhole surgery or cartilage regeneration may be possible. If your whole ankle has more advanced arthritis, then an ankle replacement or an ankle fusion may be the best option for you, and this can be discussed during your appointment.

    An ankle replacement involves removing the worn surfaces of your ankle joint and replacing them with a specially designed joint replacement made of metal and plastic. This keeps your ankle moving and gives good pain relief. Over time your implanted joint can wear out and need replacing, and the time it will last depends on your lifestyle, activity level and body weight.

    An ankle fusion involves removing your worn-out joint surfaces and fixing your ankle joint at 90 degrees by holding the bones together with metalwork until they heal together. This can be done via keyhole surgery in most cases. This stops the ankle moving completely but gives very reliable pain relief that is long lasting.

Book face to face or remote consultations

Email admin@footandankleexpert.co.uk to book your face to face or remote consultations.

Book consultation

 

 

Facebook Twitter Youtube Quote Linkedin instagram