Arthritis itself means joint inflammation. It causes swelling and pain.  Eventually, arthritis results in loss of the joint function, deformity and discomfort in walking. The most common type of ankle arthritis is post-traumatic arthritis – an old ankle injury or fracture cause wear and tear of the joint surface.  Ankle arthritis is estimated to affect 1% of the population

Common symptoms of ankle arthritis

  • Ankle Pain: You will experience pain in your ankle which can sometimes extend to the lower shin. This pain can be sharp or dull and intense.  Often it may come and go. In the early stages, you might experience pain while performing certain activities like extended walking, jogging or playing golf.
  • Stiffness: As the cartilage becomes more damaged your ankle stiffens.  Movement is limited, making it difficult to go upstairs or inclines.
  • Inactivity: As your arthritis reaches the further stage, your ankle will get stiffer due to the prolonged inactivity.  Getting out of the bed or chair can be difficult due to the pain and stiffness.
  • Swelling: When the ankle cartilage wears out, the bones of the ankle joint start rubbing each other.  The ankle joint produces fluid in an effort to lubricate the joint.  This causes ankle swelling.
  • Popping/Crunching: This is an indication that your cartilage is damaged and bone is exposed.
  • Instability: Some people experience ‘giving way’ of the ankle.  This may be due to damage to the ligaments from a previous injury, or it may be due to the ankle joint changing position.
Illustration of arthritic ankle joint

In the early stages of ankle arthritis, these symptoms come and go.  As the joint becomes more worn out, the may symptoms get worse and more persistent.

Diagnosis and Treatment of Ankle Arthritis

If you have some or all these symptoms you should consider seeking advice to see your options. With proper treatment, you can address the pain and joint deformity.

Ankle X-ray

The most common tests for confirming arthritis are x-rays.  Sometimes a CT scan, bone scan, or MRI is needed.

Once arthritis is confirmed, your treatment will depend on how much cartilage remains.  Pain killers, steroid or hyaluronic acid injections can help in the early stage.  If you are over-weight, losing weight will reduce the forces going through the joint and help with the pain.  Certain types of insoles or custom made orthotics or splints can also be of significant help for certain patients.  There may be a role for newer therapies, such as PRP or Stem cells.

If the joint is more severe, surgery may be recommended.   Keyhole surgery to remove extra bone and tidy up the joint can help for focal wear and tear.  Replacing the joint with a Total Ankle Replacement may be beneficial.  For some patients with severe degeneration and deformity, a fusion of the ankle joint, is an option.

After the surgery is done, you have to go through a period of rehabilitation. You may have to wear a brace or custom insole until you fully recover. Extra care will be needed until you can walk without pain or discomfort.  It is estimated that a patient can begin walking again in 4-6 weeks following surgery.