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Arthritis in any joint is damage to the cartilage within the joint. In the ankle we’ll oftentimes see that following a trauma, and up to 60% of patients with arthritis in the ankle are following a trauma. Because of that, we see it in the younger patient population, oftentimes people even in their 20s or 30s. They typically will present with activity-related pain, most often in the front portion of the ankle joint.
Nonsurgical treatments for ankle arthritis include anti-inflammatory medications, bracing, and occasionally cortisone injections can all be very helpful in the treatment early on.
Surgical options for the treatment of ankle arthritis depend on the degree of joint involvement. For small areas of cartilage damage we can sometimes fix this through an arthroscope. For more involved or generalized arthritis, our options are limited to replacement and fusion. A fusion procedure involves putting screws across the joints and restricting the motion. This is sometimes the best option in younger patients with post-traumatic arthritis— particularly in laborers. The disadvantage is you restrict motion of the joint, and you may predispose to later arthritis of adjacent joints. Advantages of a replacement are that you keep the motion that you have and may minimize risk of damage to the adjacent joints down the line.
Midfoot arthritis will typically present with pain-related activity over the top of the foot. A lot of times people will also complain of shoe wear. If anything is tight on the top of their foot, it really bothers them. A lot of this is osteoarthritis or just typical wear and tear, but we also see it after prior traumas as well.
Early on, the treatment of midfoot arthritis includes anti-inflammatory medications, occasionally arch supports or orthotics in the shoes, and cortisone injections into the joints. When those treatments don’t work surgery is a possibility and typically includes fusing of those joints.
UPMC has a team of experts in foot and ankle with great experience in treatment of arthritis of the foot and ankle. We do everything from straightforward and early on cases of arthritis to very difficult surgeries involving ankle replacements. We involve the patient throughout the process in terms of getting the best outcome possible.