Ankle Arthritis: Causes and Treatment

We know arthritis often shows up in the knees and hips but can you also develop it in the ankles?

Arthritis, the leading cause of disability in the U.S., can develop in any of the body’s joints. More than 100 different types have been identified, and there is every reason to believe that more will be added to the list. When we think about arthritis, we usually focus on the pain, swelling and decreased function that occurs in the knees and hips, as well as the morning stiffness and pain in the fingers and hands. There are other places that arthritis can have a significant impact. 

The presence of arthritis in the ankle is far less than the incidence of this disease in the hips and knees. Nevertheless, it is a potentially debilitating condition. Symptoms include pain and swelling, as well as joint instability and even deformity. The damage to the joint may lead to the need for ankle replacement surgery or fusion of the bones in the joint. 

Ankle arthritis develops in the tibiotalar joint, which is where the tibia (shin bone) and talus (ankle bone) come together. It is typically caused either by an injury to the ankle or as the result of some underlying condition. Osteoarthritis, which is the gradual wearing away of the cartilage in the joints that keeps the bones from rubbing against each other, is most often the number one cause of pain, swelling and decreased mobility in most joints. With the ankle joint, however, the diagnosis is more often post-traumatic arthritis. 

Post-traumatic arthritis often develops in a joint that has been injured. This is the case even with injuries that healed with no apparent issues and when full function was restored to the joint. There may not be any symptoms of arthritis for years or even decades, but degeneration, set into motion by the trauma, more often than not leads to the development of arthritis. In fact, current estimates indicate that arthritis follows an injury to the ankle in nearly 4 out of 5 cases. 

Treatment Options for Ankle Arthritis

Research is ongoing but, at the present time, there is no cure for ankle or any other type of arthritis. That said, there is a range of treatment options to relieve the symptoms and slow the progression. Your healthcare professional will typically recommend some combination of:

Non-invasive Recommendations

  • Behavioral and lifestyle changes – these may include minimizing the actions that aggravate the pain and swelling, reducing impact on the ankle, and losing weight
  • Physical therapy
  • Braces, boots, inserts and orthotics to relieve pressure on the joint
  • Medications to reduce pain and inflammation
  • Cortisone injections

Surgical Options

In those cases in which the damage is severe and more conservative options have not proven successful, your orthopedist may recommend arthrodesis, more commonly known as ankle fusion, or ankle joint replacement surgery, also called arthroplasty. 

  • Ankle fusion – this procedure reduces painful symptoms by fusing the offending bones together.
  • Ankle joint replacement surgery – just like in knee or hip joint replacement surgery, the damaged bone and tissue is replaced with plastic or metal, allowing the joint to function normally again. 

If you have questions about arthritis or about any other foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC. To schedule an appointment, or if you just have questions, please use our convenient online contact form by clicking here.