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Ankle Arthritis

What is ankle arthritis?

The ankle joint is formed by the lower end of the tibia (shin bone) and the talus (ankle bone).

X-ray showing osteoarthritis in an Ankle Joint

In normal joints there is a layer of tough slippery material called cartilage, which acts as a shock absorber and allows smooth gliding motion. In osteoarthritis the cartilage thins out and becomes rough. When this happens the tissues in your joint work harder in a process of wear and repair.

Often extra bits of bones form which, together with scarring of the joint lining, are responsible for joint stiffness. Pain and stiffness are the two main symptoms of ankle arthritis.

What causes ankle arthritis?

Most cases of ankle arthritis are secondary to injury, for example, occurring years after an ankle fracture or even several severe sprains. It can also be caused by rheumatic conditions such as rheumatoid arthritis or gout which can lead to damage and destruction of joints.

In some cases of ankle osteoarthritis there is no known cause (other than genetic). In this situation, other joints may be affected such as your hands, knees, or hips, and there may be a family history of similar issues.

We are more prone to develop osteoarthritis over time and it is more common in people over 40. Being overweight is also an important factor in causing osteoarthritis in weight bearing joints.

What tests may be done?

In the majority of cases of ankle osteoarthritis you do not need an x ray or any other tests to confirm what is wrong, unless your problem is severe enough that we may consider surgery.

What can you do to help your Ankle Osteoarthritis?

There are many non-surgical treatments that can help.

Diet: Losing weight will reduce the strain on your ankles.

Medication: Painkillers such as paracetamol can reduce the pain. Follow the advice from your community pharmacist or other healthcare professional about taking medication. It is important to take medication regularly.

Ice packs: can also help with pain.

Exercise: helps build the strength of the muscles, which can take the strain off the joint and you can choose from many non-impact activities such as swimming or cycling.

Walking aids: A walking stick or cane can be very helpful.

Footwear: Supportive boots, shoes or insoles may help.

Wearing supportive boots, shoes or insoles may help with ankle arthritis

Exercise videos

The videos below show exercises that may be useful in strengthening the muscle to help it cope better with the demand that you are placing on it.

Don’t expect things to improve overnight though. It takes time for muscles and joints to adapt and get stronger.

What else can be done?

Most patients with ankle arthritis respond to non-surgical treatments where these have been tried and failed then there may be other options. If your pain does not start improving after a period of 3 months of following the advice above, please phone 0141 347 8909 to see a healthcare professional who can assess your foot.

Some patients may be referred on for a surgical opinion.

Types of Surgery

Keyhole (arthroscopy) surgery may be helpful in some patient in earlier stages but when the problem progresses there are 2 main surgical options.

Ankle fusion (arthrodesis) this is where the ankle is surgically stiffened by fusing your tibia (shin) to your ankle (talus). The damaged joint surfaces are removed and held together with some metalwork. This converts a stiff, painful joint into a stiff but pain-free one.

Ankle replacement (arthroplasty) where the worn-out ankle joint is replaced by resurfacing the ends of your tibia and talus with metal components with a plastic insert in-between them to allow gliding.

One option or the other may be better for certain people depending on a number of reasons.

Both operations mean you would need to spend several week in a plaster cast and / or boot and would require most people to be off from work in a physical job for around 4-6 months.

Leaflets and advice

Versus Arthritis – Offers a selection of self-help booklets, which can be downloaded on the Internet.

British Orthopaedic Foot & Ankle Society (BOFAS) – Offers a selection of patient leaflets and list of all surgeons carrying out specialist ankle surgery across the UK.