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Ankle Arthritis

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Orthopaedics 360

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The ankle joint is largely responsible for flexion and extension movements. The ankle joint itself is made up of the two bones in the lower leg (tibia and fibula) and the talus (large bone that connects to both the tibia and fibula). The talus is a unique dome shaped bone. It has the highest percentage of articular cartilage coverage of any bone in the body, approximately 60% of its surface area.

Ankle anatomy adelaide orthopaedic surgeon mike smith ankle arthritis ankle arthroscopy treatment best image
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Why do people get ankle arthritis

Why do people get ankle arthritis mike smith orthopaedic surgeon
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Primary Ankle Arthritis 

Unlike Hip and Knee arthritis, primary ankle arthritis is rare. Primary ankle arthritis indicates that there is no known underlying cause as to why the arthritis has developed.

Secondary Ankle Arthritis 

The most reason for someone developing ankle arthritis is having a previous injury, or injuries, to the ankle joint. This can either be a previous ankle bony fracture (‘break’), or previous ankle sprains. Secondary damage occurs to the joint surface and with time, irreversible arthritis occurs.

Other causes include inflammatory conditions that affect multiple joints, such as Rheumatoid Arthritis or Gout, or the development of an infection within the joint.

Ankle Arthritis – What symptoms should you expect

 

 

Do you experience any of these?

Classically pain, stiffness, swelling, and difficulty walking are present. During the early phases of the condition the pain may be limited to exercise, or only present at the extreme of ankle motion. With time, the arthritis involves more of the joint, and pain at rest occurs.

clinical deformity ankle arthritis requiring ankle fusion
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The symptoms of ankle arthritis vary based on the severity of the joint surface damage, and the functional level of the individual.

Large bony protuberances (Osteophyte’s) can form, resulting in a change to the shape of the ankle.

Recurrent Ankle sprains can lead to Ankle Arthritis

What Imaging is needed

Usually plain Xrays + CT scans

Plain weight bearing ankle xrays show the extent of the arthritis, and allow assessment of other ‘joints’ within the foot, including the subtalar joint (joint below the ankle joint) and midfoot joints.CT scans also help show the degree of ankle involvement and help assess the surrounding joints of the foot.

ankle arthritis CT scan treatment of ankle pain adelaide orthopaedic surgeon mike smith
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What are the non operative options

Treatment is aimed at minimising the symptoms of pain while restoring function. Specialised footware, such as ankle orthoses, can be beneficial in reducing the forces that are going through the arthritic ankle joint.

ankle replacement ankle arthritis mike smith adelaide orthopaedic surgeon orthosis
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Have you previously injured your ankle?

Do you have a painful ankle following an old injury?

You may have developed secondary ankle arthritis

Ankle Arthritis Treatment Options

Ankle Arthroscopic Debridement

In the early phase of ankle arthritis, tibial spurring (bony growth) can occur at the front of the ankle joint. This can result in painful impingement and often responds well to keyhole decompression.

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Ankle Joint Fusion

The gold standard of surgical treatment for ankle arthritis is to perform a fusion. Patients with advanced ankle arthritis typically have very limited ankle joint motion, but what motion they do have is painful. A ‘Fusion’ procedure involves eliminating this small degree of painful motion by removing the remaining joint cartilage and joining the tibia and the talus together.

ankle fusion ankle arthritis ankle pain mike smith adelaide orthopaedic surgeon best image
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Ankle Joint Replacement 

In a small subset of low demand patients, an ankle joint replacement may be an appropriate treatment option. This involves replacing the arthritis joint with an artificial joint.

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Have you previously injured your ankle?

The most common cause for developing ankle arthritis is previous ankle sprains or fracture.

With time, arthritis may develop leading to daily pain.

 

Ankle sprains and arthritis

People don’t generally tend to associate ankle sprains with ankle arthritis due to its seemingly innocuous presentation in comparison to ankle fractures or dislocations, however recurrent ankle sprains can result in serious trauma to the ankle. Post traumatic...

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Disclaimer: Please note that this is general advice only - for more information, please consult your regular doctor, or obtain a referral to see a specialist orthopaedic surgeon. 

Orthopaedics 360

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