What makes up the ankle joint?
The ankle joint is found between three bone. They are the tibia (shin bone), the fibula and the talus (ankle bone). It carries the entire weight of the body through a relatively small surface area and is adapted very well to do so.
What causes ankle arthritis?
Arthritis means 'pain in a joint'. Causes of ankle arthritis are:
Osteoarthritis, also known as degenerative or "wear and tear" arthritis, is a common problem for many people after they reach middle age. The smooth, gliding surface covering the ends of bones (cartilage) becomes worn and frayed. This results in inflammation, swelling, and pain in the joint. Osteoarthritis progresses slowly, the pain and stiffness it causes worsens over time.
Unlike osteoarthritis which follows a predictable pattern in certain joints, rheumatoid arthritis is a system-wide disease. It is an inflammatory disease where the patient's own immune system attacks and destroys cartilage.
Can develop after an injury to the foot or ankle. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, severe sprain, or ligament injury.
What are the symptoms caused by this condition?
Symptoms vary depending on the severity of the arthritis. You may experience:
- Pain and stiffness
- Swelling over the affected joint
- Reduced range of motion
- Difficulty in walking due to any of the above and a limp
How is this condition diagnosed?
Your consultant will examine your foot clinically and this usually makes the diagnosis clear. X-rays of the ankle will also be taken to determine the degree of arthritis.
Can the condition worsen?
Ankle arthritis pain initially can be a nuisance factor. It may however progress gradually over many years to cause significant pain and restricted mobility.
What treatment options are there?
Options are based on the severity of symptoms. Most patients are seeking advice and reassurance. Non surgical options are:
- Foot wear modification: Wearing a shoe with good ankle support such as lace up boots may help to reduce the movement of the ankle. A 'rocker-bottom' shoe may also help as it allows the ankle to rock forward rather than bend during gait. An 'ankle foot orthosis' is a splint which may be worn within regular footwear and also help with the symptoms. Mr Shariff will explain how this works in greater detail.
- Steroid injections: These can be given for relief of pain in the short to medium term. These can be offered for an acute flare up of symptoms and help by reducing the inflammation in the joints.
Is surgery necessary?
The decision to proceed with surgery should be taken after non surgical options described above have been exhausted. The majority of patients will benefit from shoe wear modifications. If symptoms continue to affect lifestyle and function then surgery may be discussed with your consultant and he will advise you regarding the pros and cons of surgery. Broadly speaking there are two operations which may be considered. An 'ankle fusion' ( which is the gold standard procedure) and a 'total ankle replacement', which has become more reliable and a safe option with advances in implants. However the indications for each of these surgeries are different and a detailed discussion regarding the pros and cons of surgery will be undertaken by your consultant to give you all the information necessary to make the decision best suited to you. Further information on these procedures is available under the 'information on surgical procedure' section of this website.