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Todd Borenstein MD

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Ankle Arthritis

Ankle arthritis results from loss of cartilage in the ankle joint, which leads to pain and swelling. These symptoms are often aggravated by increased activity, and can lead to a painful limp.

What causes arthritis?

Arthritis of the ankle is often due to trauma such as an ankle fracture or recurrent ankle sprains, but may also be due to irregular loading of the joint from deformity, or from inflammatory arthritis such as rheumatoid arthritis, gout or joint infections.

What are the symptoms of ankle arthritis?

Patients with ankle arthritis often complain of ankle pain, a painful limp, stiffness in the ankle joint and swelling. When the arthritis is severe, patients may feel grinding in the joint.

How is ankle arthritis diagnosed?

Loss of cartilage in the ankle joint is most often diagnosed with medical history, physical examination and with X-rays. X-rays will show loss of joint space, bone spurs and sclerosis (whitening of the bone at the joint). Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans can also be used to diagnose ankle arthritis.

How is ankle arthritis treated?

Nonsurgical treatment

Nonsurgical treatment for ankle arthritis is meant to improve function and decrease pain. These treatments consist of activity modifications and weight loss (to limit loading through the joint), medications and injections (to decrease symptoms of swelling and pain) and physical therapy, ankle bracing, orthotics and comfort shoes (to improve joint kinematics).

Operative treatment

Operative treatments are used when nonsurgical treatments are unsuccessful. Ankle arthroscopy is a common operative treatment used to clean out the joint. Ankle arthroscopy is a surgical procedure where a small camera and instruments, roughly the size of a pencil, are inserted into the joint through small incisions to remove inflamed tissue, bone spurs, and loose pieces of bone and cartilage.

When the arthritis is more severe, ankle fusion and ankle replacement (arthroplasty) may be performed. Ankle replacement involves removing the damaged bone and cartilage and replacing this with an artificial joint. The goal of the replacement is to relieve pain while maintaining ankle motion.