What is Ankle Arthritis?
Arthritis is a degenerative disease that results from
destruction of the cartilage in your ankle. Where your
shinbone (tibia) and anklebone (talus) meet, the bone
surfaces that rub together are covered by cartilage.
It is normally very smooth and lubricated with joint
fluid that allows nearly frictionless motion of the
joint. When arthritis affects a small area of joint
cartilage, it loses its smooth glistening surface and
becomes rough and irregular. The result is further destruction
of the rest of the joint as the imperfect surfaces contact
one another. To limit motion in an arthritic joint,
your body may attempt to create new bone surrounding
the joint as a response to the destruction. But these
painful bone spurs in the front of your ankle cause
a condition called anterior impingement syndrome, which
can be a sign of ankle arthritis. Eventually, pieces
of cartilage can break off and float in the joint fluid,
causing further destruction to the once-smooth surfaces.
The end result is partial or complete destruction of
the joint and, finally, deformity.
The most common
form of arthritis is called osteoarthritis. The wear
and tear of sports and activities may put active people
at risk for osteoarthritis, but it can also be a hereditary
condition. Other types of arthritis are forms of systemic
inflammatory diseases that are not necessarily related
to sports or activities, as there may be genetic causes
for the development of this type of arthritis. The most
common of these is rheumatoid arthritis, which is thought
to be a result of the body’s immune system attacking
body tissues such as cartilage. This discussion addresses
osteoarthritis in the ankle.
may begin after repeated minor injuries to your ankle
or a specific traumatic injury - especially a fracture.
Overuse and years of chronic stress on your ankle may
also cause arthritic deterioration. Though physicians
are not exactly sure what causes osteoarthritis, many
contributing factors have been identified that put people
– The majority of people who suffer from arthritis
are over the age of 45. By age 60, most people have
some signs of mild osteoarthritis. However, athletes
and active people may be at risk of developing osteoarthritis
at a younger age because of the added stress that activities
place on their joints.
– Some people who suffer osteoarthritis may have
inherited a propensity to develop the disease.
– Extra pounds put added stress on your ankles.
Controlling your weight can help relieve some of the
pain associated with arthritis.
– Overuse is the most common activity associated
with osteoarthritis, as it contributes to wear-and-tear
and can erode ankle cartilage.
body structure – Joints that are not aligned properly
or not matched in size, length, or strength may cause
slight imbalances that put added stress on your ankles
and may cause premature arthritis.
R. Manning, M.D.,
team physician for the Dallas Burn.
osteoarthritis generally continues to progress unless
it is treated. Though there is no cure for arthritis,
most people can slow the progression of the disease
if they seek early treatment. Treatment is necessary
because your cartilage has no direct blood supply and
usually cannot heal on its own. In addition, cartilage
cannot regenerate. Younger people have a better ability
to heal small areas of damaged cartilage without undergoing
surgery. Active people over 40 are more likely to develop
osteoarthritis as a complication of an injury. However,
arthritis can occur after a significant injury at any
age. Most patients are treated conservatively because
surgery to treat ankle arthritis is usually a major
operation. The initial symptoms often can be treated
with rest, shoe modifications, bracing, and anti-inflammatory
medications. Most younger people with signs of early
arthritis can return to some type of activity after
non-operative treatment. As the disease progresses,
surgery, which may be fusion of the your ankle joint
or a total ankle replacement, may ultimately be required.
Surgery is primarily prescribed for older patients who
have been unable to walk more than a few blocks for
months or years. After ankle fusion surgery and total
ankle replacement, pain typically goes away and you
can get around again, but you usually can no longer
participate in most sports activities that involve bearing
weight on your ankle. The links to the left explain
standard ankle osteoarthritis treatments in detail.p;nav=Pat"
R. Manning, M.D., team physician for the Dallas
There usually are three
parts to an orthopedic evaluation: medical history,
a physical examination, and tests that your doctor may
Your physician will likely ask
you when you noticed your ankle pain, how it has been
feeling since the pain began, and if your ankle was
injured previously. You should reveal any relevant ankle
surgery history at this time. Arthritis is suspected
when you have a history of chronic swelling in your
ankle, pain with walking a certain number of blocks,
and limited activity participation because of your ankle
pain. Physicians also typically ask about other conditions,
such as personal habits, other medical conditions like
diabetes and allergies, and medications currently being
taken. You may also be asked about your physical and
athletic habits and goals – information that will
help decide what treatment might be best for you in
achieving your goals.
Your physician typically presses areas all around your
ankle to see where your joint is tender. Your ankle
is moved in all directions to test the joint’s
range of motion. When your physician moves your foot
up and down and compares it to the other side, your
arthritic ankle often cannot move as far.
X-rays of your ankle usually are taken while you are
standing up, so that your physician can see your ankle
as it bears your body weight. X-rays usually can reveal
arthritic degeneration, and may show narrowing of the
ankle joint space between the shinbone and talus, deformity,
loose bone fragments, bone cysts, or other types of
bone damage. Most patients with osteoarthritis will
only require an X-ray unless the diagnosis is in doubt.p;nav=Pat"
R. Manning, M.D., team physician for the Dallas