What is ankle arthritis?

Ankle arthritis occurs when cartilage in the ankle joint gradually erodes. Cartilage is a rubbery tissue that allows bones to glide smoothly over one another. Without the cushioning effect of cartilage, the bones of the joint rub together. The ankle can't move easily and becomes stiff, swollen and painful, particularly when walking.

There are several types of ankle arthritis:

  • Osteoarthritis is the most common form. Also called “wear and tear” arthritis, it is a progressive, degenerative disease in which the surface layer of cartilage slowly wears away. Osteoarthritis is especially prevalent among middle-aged and older adults. Obesity and genetics are also contributing factors.
  • Rheumatoid arthritis is an inflammatory condition that destroys joint cartilage. It can occur at any age and generally affects both ankles.
  • Post-traumatic arthritis can develop after an injury to the foot or ankle. It is similar to osteoarthritis and may result from a fracture, severe sprain or ligament injury.

What are the symptoms of ankle arthritis?

Symptoms of ankle arthritis typically include:

  • Tenderness or pain
  • Reduced ability to move, walk or bear weight
  • Balance issues
  • Stiffness or swelling in the joint

How is ankle arthritis diagnosed?

In addition to a physical exam and health history, your doctor can use specific tests, including X-rays, MRIs or CT scans, to diagnose ankle arthritis.

What is the treatment?

There is no cure for ankle arthritis, but proper treatment can slow its progression, reduce pain and increase function. Patients are encouraged to try these non-operative options first:

  • Weight loss. Simple weight loss can reduce stress on the joint. If you're overweight, losing just five percent of your current weight can improve your arthritis symptoms.
  • Exercise/physical therapy. Exercise is important to lubricate the joint, strengthen surrounding muscles, maintain bone strength and control weight. Non-impact exercises are best. Your doctor or physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.
  • Medication. Acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and topical creams and sprays can combat pain and inflammation. If over-the-counter medications don't provide relief, your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain.
  • Injections. Corticosteroids are powerful anti-inflammatory drugs that can be injected directly into the ankle to help temporarily relieve pain.
  • Custom braces and supports. These may include pads or arch supports, specially made orthotics or shoes, and canes or braces to support the ankle joint.

If these non-operative treatments don’t work, surgery may be necessary. The type of surgery you have depends on the severity and extent of your arthritis. Sometimes, more than one type of surgery is necessary. It’s important that a qualified foot and ankle surgeon assess your condition to determine the option that is best for you. The most common surgical treatments for ankle arthritis include:

  • Arthroscopic debridement (ankle arthroscopy). The surgeon uses using tiny instruments to clean the joint area of foreign or inflamed tissue and bone spurs. Arthroscopy may be helpful in the early stages of arthritis.
  • Fusion surgery (arthrodesis). The surgeon fuses the bones together with rods, pins, screws or plates. If there is significant bone loss, a bone graft may be needed to aid healing.
  • Joint replacement. In some cases, total joint replacement is necessary. The surgeon replaces the damaged ankle joint with an artificial implant, called a prosthesis. Although not as common as hip or knee replacement, ankle replacement is a feasible option for many people.

Recovery time varies by patient and the procedure performed. Advancements in minimally invasive approaches, improved implant material and design, and refined surgical techniques have dramatically reduced recovery time. For most patients, the typical recovery period is now weeks rather than months.