The ankle joint is made up of the end of the tibia (shin bone) and the talus (ankle bone) in the foot. It is shaped so that the main movement of the joint allows the foot to move smoothly up and down. As with other load bearing joints the surface of the ends of the bone are covered with smooth hard wearing cartilage and when this wears away as part of the arthritic process the joint becomes painful as bone rubs on bone.
The most common cause for the wear of this smooth lining (cartilage) is osteoarthritis however other causes include previous fracture, infection or rheumatoid arthritis.
What are the symptoms?
The most common symptom patients experience is pain and swelling around the ankle joint which is worse on moving around when walking. The joint often can change shape slightly as the wear and tear progresses and can result in you only being able to walk short distances and even in severe cases being woken at night.
How is it diagnosed?
The diagnosis starts with a through history and examination and if appropriate x-rays will be arranged to investigate the extent of the wear and tear changes. In certain situations a MRI scan may be necessary in order to view the ankle in more detail.
How is it treated?
Non-operative treatment – can be helpful in the initial stages to help reduce your symptoms.
The options include: -
- Supportive footwear such as boots or using a brace. Both of these can help stabilize the ankle when walking.
- Simple painkillers such as anti-inflammatories
- Steroid injections into the joint to reduce joint swelling and discomfort.
Operative treatment – as with any arthritic joint when the symptoms of pain and discomfort deteriorate to the extent that your quality of life is affected then it is time to consider surgical procedures.
- Ankle arthroscopy (key hole surgery) – through two small incisions around the ankle a camera and instrument can be passed into the ankle joint and the joint surface can be cleaned (debrided) potentially improving pain and movement. This may not always be possible depending on the extent of the arthritic changes in the joint.
- Ankle replacement – this replaces the bottom of the shin bone (tibia) and top of the ankle bone (talus) with a plastic insert between these two components. This aims to maintain the movement in the ankle joint and relieve pain but has the down side of a less predictable long term outcome currently however this may change as things develop.
- Ankle fusion – this involves fixing/stiffening the ankle in one position which prevents the raw bone surfaces moving against each other when walking. The procedure is very reliable in getting rid of pain and allows restoration of an active lifestyle.
Important: this information given above is only a guideline as is not complete. For more information or to book an appointment please contact us.