The ankle joint is much less frequently affected by arthritis than other joints. When patients have ankle arthritis, they have worn down the tibial joint, the joint between the tibia (shinbone) and the ankle bone (talus).
Previous ankle injury is the most common cause of ankle arthritis. In people who have suffered injuries such as ankle fractures, cartilage can become damaged, which can lead to accelerated arthritis. When the ankle is injured, it is also susceptible to an injury called osteonecrosis. When osteonecrosis occurs due to ankle injury, blood flow to parts of the bone is compromised. Osteonecrosis can also lead to ankle arthritis.
Another cause of ankle arthritis is rheumatoid arthritis. Rheumatoid disease can cause joint inflammation and cartilage damage. Over time, this can cause serious problems that require treatment.
Joint infections that cause chondrocyte damage are another cause. Because chondrocytes cannot regenerate, damage from infection can last forever.
While the influence of genetics on the development of arthritis is unclear, it has been observed that some people have a genetic predisposition to wear out their joints faster than others.
Weight is another common factor in ankle arthritis. People who are overweight place a greater burden on their weight-bearing joints—the hips, knees, ankles, and their feet. They are more likely to develop arthritis and tend to have more accelerated damage to the articular cartilage.
Ankle arthritis often causes pain around the ankle joint, and the most common reason patients seek treatment is for pain associated with this condition. Other common symptoms of ankle arthritis include:
- Ankle stiffness
- swelling around the joint
- Bone spurs cause joint lumps
- joint deformity
- instability, or a feeling that the joint may “give”
Less commonly, ankle arthritis can cause irritation of the nerves around the joint, leading to tingling and numbness in the feet and toes.
Ankle arthritis can be easily diagnosed with exams and X-rays. Once the patient is diagnosed, non-surgical treatment should be attempted. Most patients find relief with steps that include activity adjustments and footwear changes.
Treatment of ankle arthritis should always begin with simple steps rather than surgery. One of the easiest steps to take is to try some shoe modifications. Cushions can help relieve symptoms. Another helpful step is to have a shoe repair specialist add a “rocker sole” to the sole.
To help support the joint and prevent excessive movement, a brace can be made to help keep the ankle joint in place. These braces are called ankle-foot orthoses, or AFOs.
Patients should try to limit impact activities, including running and jumping. Mobility adjustments like this are an important part of treating ankle arthritis.Patients who are unwilling to change their lifestyle should generally no Consider surgery.
In addition to changing physical activity, medication can also be an effective treatment. Anti-inflammatory drugs are helpful for people with moderate symptoms. Patients should use these drugs with caution because of possible side effects, especially with long-term use.
Cortisone injections are very helpful in the treatment of ankle arthritis, especially during acute attacks of pain. While regular cortisone injections are not available, occasional injections are helpful for most patients with ankle arthritis.
If these treatments do not relieve ankle pain, then more invasive surgery may be considered.
Ankle arthroscopy can be used in patients with localized ankle arthritis, but is usually ineffective for more extensive ankle arthritis. This type of surgery is most helpful when small bone spurs develop around the joint causing a “bump,” which means the spur is squeezed as the ankle moves up and down. During arthroscopic surgery, bone spurs may be shaved to facilitate movement of the joint. Unfortunately, if ankle arthritis is more extensive, this type of surgery may not help. When a lot of cartilage is worn away, the joint will not benefit from this surgery.
Ankle fusion surgery is the standard treatment for advanced ankle arthritis. This surgery removes the worn part of the joint and then permanently holds the bone in a stable position.
Ankle replacement surgery is the more controversial treatment for ankle arthritis. While the effectiveness of fusion surgery is still debated, there is not much experience with ankle replacement surgery. Implant designs are improving as more of these procedures are performed. This may lead to better results.
Frequently Asked Questions
What causes ankle arthritis?
Ankle arthritis is usually caused by a previous ankle injury, such as an ankle fracture. Other potential causes or risk factors include rheumatoid arthritis, joint infections that damage cartilage cells, Genetics, being overweight or obese. Less commonly, osteonecrosis can also lead to ankle arthritis. This condition refers to reduced blood flow to the bone, which can eventually lead to the death of the bone tissue.
How is ankle arthritis treated?
Treatment for ankle arthritis begins with lifestyle changes to manage symptoms, such as wearing cushioned shoes or using ankle braces for extra support. Avoiding activities such as running or jumping can also help. Anti-inflammatory medications and occasional cortisone injections may be beneficial, but require a prescription from a healthcare provider.
If further treatment is required, surgery may be the next option. Ankle fusion surgery is considered the standard of care for advanced ankle arthritis, and ankle arthroscopy may be beneficial for patients with advanced ankle arthritis.