Ankle Arthritis: Symptoms and Treatments

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credit: Cleveland Clinic 

“Time and health are two precious assets that we don’t recognize and appreciate until they have been depleted.”  – Denis Waitley 

Article Authors: Gordon Slater| Tandose Sambo 

Orthopaedic symptoms can be attributed to more than one root cause. One commonly experienced orthopaedic condition is joint pain. In some instances, joint pain can be acute, and in other instances,joint pain can be chronic. Arthritis is an orthopaedic condition that often results in chronic joint pain. As a medical condition that is induced by the breakdown of joint cartilage, arthritis impacts general mobility and quality of life. 

Movement is natural to our daily lives, and with time, there is friction between the bones that is generated in the progression of arthritis. Inflammation of the joint results, causing the sensation of pain. Ankle joint pain is often the result of strenuous activity. Studies have shown that the majority of ankle arthritis cases are actually induced by some form of physical trauma. This includes sports related injury, falls and any other impacts or collisions that induce shock to the ankle. 

Ankle injuries can affect the cartilage, ligaments and muscles of the joint. Direct damage to the cartilage, or misalignment of the joint cavity can lead to the formation of ankle arthritis. Arthritis often begins as an acute condition that degenerates if the appropriate care is not taken. Any additional strain or increased activity to the joint cavity, will cause the degeneration of the ankle joint. 

When should you visit your orthopaedic specialist? 

Normal acute ankle pain can heal with the appropriate rest conditions. If however, you find yourself having to consistently rely on anti-inflammatory medication or other pain relievers, speak to your orthopaedic specialist. There may be an underlying condition such as arthritis that is affecting your ankle. Many arthritis patients often experience a loss of flexibility in the ankle region, which is often noticeable in the mornings, or after long periods of rest. 

Your orthopaedic specialist will utilise imaging tools such as X-rays or an MRI, in order to see the internal condition of the ankle joint. Via analysis, and checks for various joint anomalies such as bone spurs or even an abnormal joint cavity, your orthopaedic specialist will be able to determine if you have ankle arthritis. There are also classification systems that are able to determine what stage of arthritis you are currently experiencing. 

Non-surgical treatments for ankle arthritis

Acute arthritis can be treated by non-surgical therapies. Initially, patients are often advised to adjust their activity levels and incorporate anti-inflammatory medicine into their regime. Weight gain can impact the stress on the joints, and patients are advised to lose weight, if the root cause was not impact or sports related. Ankle support such as braces are also incorporated. 

Advanced non-surgical treatment of arthritis involves injections of corticosteroids. Since cartilage is a lubricant, an alternative treatment involves viscosupplementation. Via this procedure, a lubricating fluid is injected into the ankle joint in order to enable it to operate smoothly, and minimise bone friction. 

Surgical options

Severe cases of arthritis are often not treatable by non-surgical methods. Patients may often experience arthritic pain and stiffness, after the implementation of non-surgical methods. The utilisation of surgical treatments for arthritis is a plan of last resort. Minor orthopaedic treatments such as arthroscopy are often used. For more advanced cases of arthritis, ankle fusion and ankle replacement are often utilised as corrective procedures.

Ankle fusion: Alternatively known as ankle arthrodesis, the procedure involves the reinforcement of the bones of the ankle via a series of strategically placed plates and screws. As the pain and discomfort of ankle arthritis and other conditions worsens, ankle fusion is one of the best ways that patients can relieve their pain, and resume a normal lifestyle. While no procedure is devoid of risk, the benefits of ankle fusion will outweigh the risks. Risks of ankle fusion include: scarring, infection, swelling of the ankles and adjustments in the gait. 

Ankle Replacement: Ankle replacement, involves joint restoration via the removal of the joint internals, and replacing them with prosthetics. These are synthetic joints which are made of plastic and metal, as indicated in the image. The original joint is classified as damaged, and the replacement joint aims to restore the damaged portion of the joint. With joint replacement, there is increased mobility, but still has the ability to regenerate arthritic conditions. Ankle replacement surgery is often prescribed for patients over the age of sixty, who restrict their physical activity. 

With a variety of treatment options available for ankle arthritis, seek the consultation of your orthopaedic specialist in order to determine the best path for you. 

Article Reference: Adventist Health 

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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