Ankle Arthritis Causes, Symptoms & Treatment Options

The ankle joint is made up of three bones, the tibia or shin bone, the fibula a thin bone on the outside of the leg and the talus which sits  on top of the calcaneus or heelbone. Covering these bones is a smooth rubbery substance called articular cartilage that serves as a cushion and allows the bones to smoothly glide over one another. Ankle arthritis is a condition where there is a breakdown or loss of this cartilage. As the cartilage is lost the bones rub against one another causing pain and stiffness and loss of motion

While there are many causes of ankle arthritis, the most common is due to “wear and tear” This is commonly referred to as degenerative arthritis of the ankle. Another common cause of ankle arthritis is called post traumatic arthritis which occurs after an ankle injury. Sometimes the symptoms may take years to appear. Ankle arthritis may also be seen in diseases such as rheumatoid arthritis, psoriatic arthritis, and gout.

Common symptoms of ankle arthritis include:

Pain with ankle motion

Increased pain with sitting or resting

Stiffness and swelling

Difficulty walking

While there are many causes of ankle arthritis, the most common type is osteoarthritis arthritis or “wear and tear “arthritis of the ankle. This is also referred to as degenerative arthritis of the ankle This occurs more often in older people but may occur in middle aged people as well.Post-traumatic arthritis, or arthritis after an injury may take many years to develop, It usually occurs after a fracture or dislocation of the ankle.Ankle arthritis may also be seen in diseases such as rheumatoid arthritis, psoriatic arthritis, and gout.

The symptoms of ankle arthritis  generally develop gradually over time although a sudden onset is possible. The most common symptoms are pain and stiffness of the ankle joint.

Other  symptoms may include:

Pain with ankle motion

Increased pain with sitting or resting

Swelling

Loss of motion

Difficulty walking

If you have these symptoms, consult with your doctor. During your visit, you will be asked to provide a medical history, including your level of physical activity, any history of ankle injuries in the past and any abnormal wear and tear of your shoes. Your doctor will conduct a physical exam, looking for:

Swelling, redness, and tenderness in the joint
• Range of movement of your ankle
• Problems with the way you walk, such as a limp.

After the physical examination, your doctor may recommend an X-ray. It is important for these X-rays to be done standing or weight bearing as they give much more information to your doctor. These imaging tests provide detailed pictures of the bone and cartilage that make up your ankle and any deformities that are present.  They can help your doctor confirm the diagnosis and gauge the extent of the condition. Blood tests may also be ordered to rule out other conditions, such as rheumatoid arthritis or gout.

Arthritis of the ankle is usually treated initially non-operatively. These treatments can help relieve pain and stiffness and prolong the life of the joint. These typically include:

• Minimizing activities that cause pain such as running or jumping and substituting low impact exercises like walking or swimming
• Weight loss and general fitness
• Physical therapy and exercise programs
• Bracing and supportive shoes
• NSAIA

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Ankle Arthritis

While most ankle arthritis is treated without surgery, sometimes if the pain or deformity is more severe surgery may be recommended. Surgical options include:

• Arthroscopy-The surgeon uses a special camera to look in the ankle joint and remove loose fragments that may be causing the joint to lock up. This may be useful in the early stages of ankle arthritis
• Ankle fusion(arthrodesis)-In this procedure the surgeon removes the damaged cartilage and fuses the joint with screws and plates. The purpose of the procedure is to eliminate the motion at the ankle joint which helps to relieve the pain
• Total ankle replacement-In this procedure the surgeon replaces the damaged ankle joint with a new ankle joint to restore mobility and reduce pain

Ankle arthritis is a chronic condition that may cause pain from time to time. Recovery from a surgical procedure to the  ankle joint for ankle arthritis  will depend on the extent of the injury and type of treatment, and can range from several weeks to many months. The rehabilitation period will include a gradual return to weight-bearing activity and physical therapy.