What is it?
Arthritis is the loss of the cartilage lining the joint surface (articular cartilage). Normally this is a soft, glistening, smooth, white tissue that acts as a surface to allow the joint to move freely. If the cartilage is damaged, the surface becomes rough and no longer glides. This causes pain and stiffness within the joint. While arthritis of the hip and knee are most common, any joint may be affected.
What causes it?
- Osteoarthritis (wear and tear). This is less common in the ankle than in the hip and knee. It may be genetic (inherited), or may be due to heavy manual work but a specific cause is rarely found.
- Rheumatoid arthritis. This condition affects joints and organs throughout the body and often affects the ankle.
- Trauma. If the ankle joint has been previously broken (fractured), the cartilage may have been damaged, causing it to wear out more quickly.
What are the symptoms?
Pain is usually the first complaint. Often felt deep in the ankle it intensifies during weight bearing and is often worse at the front or when walking up hill. A throbbing pain may be experienced at night.
How is the diagnosis made?
After listening to a description of the symptoms the doctor will examine the foot and ankle. Plain x-rays are usually sufficient to make the diagnosis.
What is the initial treatment?
The symptoms of ankle arthritis can often be managed with anti-inflammatory painkillers and adaptations to supportive footwear in conjunction with an orthotist. The condition can also be improved by avoiding any activity that aggravates it.
If the initial treatment doesn't work, what's next?
- Corticosteroid injections into the ankle offer great pain relief. They also confirm the source of the symptoms should there be any doubt. But the amount of pain relief can vary significantly, as can the duration which may be as little as days or as long as months
- Arthroscopy and debridement in which the arthroscope is introduced into the ankle and any spurs of bone are removed. This may be appropriate if the spurs are the main source of the pain (impingement)
- Ankle arthroscopy Fusing the ankle joint may sound like a drastic procedure but in the correct situation, produces excellent results - see arthroscopic ankle fusion and open ankle fusion. The arthritis will have already caused reduced movement in the ankle so fusion will mean little additional reduction. However there will be improved function due to the lack of pain.
Ankle replacement is a recent development that has a definite place in the treatment of arthritis. It does not necessarily improve the movement of the ankle but produces excellent pain relief in the correct situation.
Our practice covers the following hospitals:
For appointments phone : 0208 971 8026
St Anthony's Hospital
For appointments phone : 0208 335 4678
For appointments phone : 01372 221441
Shirley Oaks Hospital
For appointments phone : 0208 6555500