25 Jan Severe Osteoarthritis of the Ankle and How to Manage the Condition
Osteoarthritis of the ankle is characterized by a chronic inflammatory response that occurs in the ankle joint causing pain and reduced mobility due to degenerative changes in the anatomy. Since the ankles have to bear up to five times the weight of a particular individual and they are constantly being used, they are exposed to constant and persistent stressors which may result in the mentioned inflammatory and degenerative processes.
The two primary processes of ankle degeneration include:
- Breakdown of the cartilage in the joints between the tibia (shin bone) and the talus (foot bone) and the fibula (smaller lower leg bone) and the talus.
- The development of abnormal bony growths, known as bone spurs or osteophytes, in the joint.
In up to 90 percent of cases of patients with ankle osteoarthritis the underlying causes may include:
- Trauma to the joint. Fractures, sprains or other injuries affecting the ankles increase the risk of osteoarthritis in the joints sevenfold.
- Underlying medical conditions such as rheumatoid arthritis.
Risk factors for developing the condition include:
- Being over 65 years of age.
- Obese individuals.
- Having a family history of the condition.
Signs and Symptoms
Patients with osteoarthritis of the ankle may present with:
- Pain and stiffness in the affected joint.
- Decreased range of motion and flexibility of the ankle.
- Referred pain to the lower shin, or back or middle of the foot.
- Intermittent nature of the pain which means it comes and goes.
- In the early stages of the condition, patients report that the pain worsens when performing activities such as running or jogging, but later the pain may even occur with rest as arthritis gets worse.
- Crunching or popping sounds due to the cartilage being worn down and the ends of the mentioned bones making contact with each other.
- Buckling or locking of the ankle when walking. This is indicative of instability of the ankle.
- A change in how the patient walks due to the pain and deformity of the ankle. This can lead to changes in the positions of other joints such as the knees and hips which increase the chances of arthritis developing in these areas.
Ankle osteoarthritis can be managed by incorporating lifestyle changes and using conservative therapies such as:
- Changing to physical activities that don’t put a strain on the ankle, such as cycling or swimming.
- Losing weight to take pressure off the joints.
- Using supportive footwear such as high top shoes or boots.
- Medications such as the anti-inflammatories to help reduce swelling and pain.
- A cold and warm compress applied to the affected joint helps to reduce swelling and promotes blood flow throughout the anatomy, respectively.
- Physical therapy provides exercises and techniques which help to strengthen the muscles around the ankle and this improves support to the joint.
If these suggestions are not effective, orthotics and intra-articular injections with steroids and local anesthetic agents may be attempted. If these therapies are still ineffective, or arthritis in the ankle is so severe that it negatively impacts the patient’s activities of daily living, they may need to have surgery performed on the ankle.
One of the surgeries which may be performed includes fusion of the ankle, also known as ankle arthrodesis. This surgery involves fusing the tibia, fibula, and talus together and the following can also be mentioned:
- This surgery eliminates bone friction thereby decreasing pain and improving the stability of the ankle.
- This is a commonly performed, safe and effective therapy for severe ankle osteoarthritis.