What is arthritis?
Arthritis is a decrease in the thickness and quality of the cartilage in a joint. This can happen in any joint.
Why does arthritis form?
There are many types of arthritis. Autoimmune disorders like rheumatoid and psoriatic arthritis are conditions caused by the body’s own cells attacking the joints. Arthritis can also be caused by a traumatic injury to the joint, like an impaction that destroys the cartilage cells or a fracture through a joint. Abnormal joint wearing caused by loose ligaments or positional deformities lead to the most common form of arthritis, osteoarthritis. The most common reason ankles become arthritic is due to previous injury.
How is ankle arthritis treated?
It depends on what has caused the arthritis and how severe the arthritis is. Conservative treatment of early arthritis consists of attempting to minimize the problem which caused the arthritis initially. If it was caused by loose ankle ligaments, we use bracing techniques to limit excessive joint motion and abnormal wear. If it is painful enough, cortisone injections can substantially alleviate pain and can last from several weeks to several months. Supportive shoes can also help to alleviate abnormal stresses on the joint. Once an arthritic joint limits daily activity due to pain, surgery can be considered.
Surgical treatment includes ankle arthrodesis (fusion) or total ankle joint replacement. Ankle fusion consists of removing all the arthritic surfaces of the joint to healthy bone. The bones are then placed in proper positional alignment and fixed in place using plates and screws. This prohibits the up and down motion of the ankle but alleviates most of the pain. Ankle replacement surgery is like hip and knee replacements in which the joint surfaces are removed and replaced by metal components and a thick piece of plastic. The procedure requires 2 weeks of non-weight bearing activity followed by a 6 week period of rehabilitation and therapy. Patients are typically able to walk comfortably around 3 months after surgery. Patients must meet certain health requirements to be a candidate for ankle replacement.