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Treating Ankle Arthritis

By Stephen F. Conti, MD

Ankle arthritis involves the loss of the normal cartilage in the ankle. Its cause is much different than hip or knee arthritis, known as osteoarthritis, which occurs most frequently with age.

Ankle arthritis almost always is a result of some kind of injury. This could include multiple ankle sprains or even a single ankle fracture, particularly if plate and screws were used to fix the fracture.

Non-surgical treatments

Initial treatments to relieve the pain of ankle arthritis can include weight loss, modified physical activity, the use of over-the-counter nonsteroidal anti-inflammatory medicine (such as ibuprofen), steroid injections, and braces.

  • Our ankles absorb tremendous body weight force, so weight loss and changes to low impact activities can help ease the pain of ankle arthritis.
  • Steroid shots, which can be given up to every three months, are usually effective in the early stages of arthritis. However, they seem to do less well when the cartilage completely deteriorates.

Surgical options

When non-surgical treatments are no longer effective, surgical options for advanced ankle arthritis include ankle fusion and ankle replacement.

In ankle fusion, the joint is removed and the two bones are put together and held with screws. This allows the bones to grow together (or fuse) to become one bone. The advantage of ankle fusion is that it offers excellent pain relief; the disadvantage is that it results in complete stiffness of the ankle.

Total ankle replacement involves removing the ankle joint. An artificial ankle, consisting of two pieces of metal with a piece of plastic between them, is then placed in the joint. This surgery offers patients both pain relief and greater mobility. However, patients may need another operation in 10 to 15 years when the plastic piece wears out.

Is surgery right for you?

The decision to have ankle fusion or ankle replacement surgery is a complicated one, based on your pain, medical health, and activity level. It is best discussed in person with your orthopaedic surgeon.

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