What is ankle arthritis?

Ankle arthritis can be caused by degeneration (osteoarthritis) or inflammation (e.g. rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis). In both cases the cartilage, which is the shiny white gristle that lines and articulates the joint, becomes damaged. This causes bone to rub on bone, which is painful.

Osteoarthritis is usually secondary to damage to the joint, for example as a result of previous fracture, repeated sprains of the ankle, malalignment of the joint or infection.

Excess body weight can overload a joint and worsen the symptoms of arthritis. Every extra kilogram of body weight is multiplied by 5 to 7 times when it is carried by the ankle.

Who gets ankle arthritis?
Anyone can get ankle arthritis. Osteoarthritis tends to become commoner as we get older; nevertheless ankle fractures, repeated sprains, and inflammatory arthritis can cause arthritis to occur at a younger age.

What are the symptoms?

Pain is the commonest and most troublesome symptom. This is usually made worse by walking. It may disturb sleep. Simple ways to see if your pain is getting worse is to record whether your walking distance is decreasing, or whether you need more painkillers to ease the pain.

With osteoarthritis stiffness, or reduced movement, is common. With inflammatory arthritis stiffness can often be worse first thing in the morning.

How is ankle arthritis investigated?

X-rays of the ankle are taken whilst you are standing. This simple test will give the most information on whether the ankle is worn or not.

Sometimes special tests are needed to determine the extent of the arthritis, or exactly which joint is involved. An MRI scan can give a lot of information on the thickness of the cartilage lining the joint, and whether there are small areas of wear and loose cartilage. CT and bone scans may also be used to investigate ankle arthritis.

Treatment: With any form of arthritis there are two forms of treatment. The first is without an operation, and the second is with surgery. Most arthritis can be treated without surgery, and only in severe arthritis will surgery be considered.

Non operative treatments: In the first instance simple modifications of the way you lead your life should be tried. These include resting when the pain necessitates, slowing down and altering sporting activities. Weight loss, supportive boots and walking sticks are also useful. The most important and effective non-operative treatment is weight loss.

Pain killers such as Paracetamol can be effective. Non steroidal anti-inflammatories can reduce inflammation. Patients need to check with their general practitioner or pharmacist that NSAID’s are suitable for them, as they can have side effects, especially if you have asthma, or stomach ulcers.

Surgery

There are three main surgical treatments for ankle arthritis.

Ankle arthroscopy

Ankle Fusion

Total Ankle Replacement

All operations have risks. If you are considering surgical treatment for your ankle arthritis please discuss this with your GP or surgeon.