What to Know About Ankle Arthritis

The foot and ankle are critical for human motion. 

With 28 bones and 30 joints as well as a number of ligaments, muscles and tendons, the foot and ankle support the body mainly by acting as shock absorbers and enabling you to balance and move. While arthritis of the ankle isn’t as common as arthritis of the hip and knee, it is still relatively common.

Ankle arthritis is more commonly related to trauma like car accidents or old ankle or leg fractures. Also called post-traumatic arthritis, this type of ankle arthritis can show symptoms years after an initial injury occurred. Sometimes it may present as chronic ankle instability, such as multiple ankle sprains or an old sports injury. However, more typical arthritis such as osteoarthritis or rheumatoid arthritis can also be seen in the ankle.

The definition of arthritis is simply when cartilage between the joints wears away, causing painful friction and bone rubbing on bone. Cartilage can break down for a number of reasons, including traumatic injury, but what’s important to understand about cartilage is that your body cannot replace it naturally. Cartilage doesn’t have any blood vessels, which oxygenated red blood cells need for repair. Symptoms of ankle arthritis can include:

• General pain, stiffness and difficulty when walking, running or moving the ankle, or intense pain with activity
• Swelling of the foot or ankle
• Pain after resting the ankle/foot, or pain deep in the ankle with attempted ambulation after sitting or sleeping for long periods of time

Initial treatment of ankle arthritis includes anti-inflammatory medicines, bracing, and possibly steroid injections. If conservative treatment fails, there are a few good surgical options.

The most common surgery for ankle arthritis is either ankle fusion or total ankle replacement, and both are excellent at offering pain relief. A total ankle replacement allows you to retain the motion you had before the injury, and usually shows improved functional parameters such as stride length, walking speed, and ability to walk on inclines. However, the longevity of total ankle replacements is still evolving and depends on each particular patient’s situation such as age and activity level. An ankle fusion also provides improved functional parameters compared to the patient’s presurgical condition. After an ankle fusion, the motion through the ankle joint is restricted, but this is made up for by increased motion in other joints in the foot and below the ankle.

If you think you may have ankle arthritis it is best to see a medical provider or orthopedic foot and ankle surgeon as soon as possible, who can help determine the best plan of care for you.

Dr. Todd A. Irwin is a fellowship-trained foot and ankle surgeon with the OrthoCarolina Foot and Ankle Institute.