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Diseases & Conditions

Ankle Arthritis and Total Ankle Replacement

Ankle Arthritis and Total Ankle Replacement

Your ankle is a tough and durable part of your body. But even the toughest body parts can wear out over time, or cause pain and discomfort because of injury or disease. This might mean that you would need an ankle replacement.

What causes arthritis of the ankle?

Your ankle is joined to your foot and your leg bone by cartilage. Cartilage is a tough, rubbery tissue that’s more flexible than bone but stiffer than muscle. Arthritis tends to attack the cartilage in places where two bones come together, which are called joints.

Arthritis can occur at any joint in the human body. A joint with arthritis can be painful, swollen, and stiff. Arthritis is more likely to occur in joints that have been injured or damaged over the years, and ankles are among the joints people injure the most. Stepping the wrong way off of a curb and twisting your ankle generally isn’t serious — but the damage that builds up over time can be.

In some people, this wear and tear that takes place over many years causes a condition called degenerative arthritis or osteoarthritis. Basically, this means the ankle joint is simply wearing out. Some doctors say worn-out joints have arthrosis. This condition is more common in older people

What are risk factors for developing osteoarthritis or arthrosis?

  • Obesity
  • Family history
  • Getting older
  • A history of injuries such as fractures

How is arthritis of the ankle treated?

People who suffer from arthritis in the ankle can get some relief in a number of different ways. Over-the-counter pain relief medicines, especially those that reduce swelling such as ibuprofen, can help. You might also try good shoes, shoe inserts, pads, and arch supports, physical therapy, and a brace or cane. If these aren’t helping, your doctor may inject medicine, such as a steroid, directly into the ankle joint.

When might surgery be suggested?

If you’re still having a lot of pain, your doctor may refer you to a surgeon for a surgical procedure. These can include arthroscopic surgery, in which a thin, flexible tube that contains a tiny television camera is inserted into the joint. This lets the surgeon see firsthand what is going on in the joint. Then, other thin flexible tubes that have very small tools attached to them can be inserted into the joint. These might allow the surgeon treat the problem.

When the arthritis is more advanced, more intensive surgery may be necessary. The surgeon may need to fuse, or combine, all the bones of the joint into one bone. This in generally done with pins, plates, and screws to fasten bones to each other. If there isn’t enough bone left in your ankle to do this, the surgeon may take a piece of bone from elsewhere in your body, such as your hip, to replace the missing bone. Although this type of surgery is generally very successful, it can result in an ankle that’s hard to move up and down.

What is an ankle replacement surgery?

A relatively new treatment option is total ankle replacement. In ankle replacement surgery, an artificial ankle joint is implanted between your lower leg bone and your foot bone. There are a number of artificial ankle devices your surgeon can choose from. They are generally made from metal and plastic parts, and are very durable.

Total ankle replacement surgery is a good alternative to ankle fusion surgery in some patients with ankle arthritis. But before considering total ankle replacement, patients should have tried at least several months of simpler, non-surgical treatment, and must have good soft-tissue coverage and blood flow to the ankle.

Studies show that total ankle replacement can safely relieve the pain of arthritis of the ankle, improve function such as walking, and allows for an improved quality of life. Ankle replacement allows many patients to retain more movement in the ankle, and have better mobility, than ankle fusion.

Who should not have ankle replacement?

Keep in mind that not every patient can receive an ankle replacement. Some patients’ ankles are unstable or deformed, and they are not good candidates for an ankle replacement device.

Total ankle replacement surgery is a complicated procedure and should only be performed by a surgeon who specializes in it.

Also, be aware that any type of ankle surgery can be painful and may require a long period of physical therapy and rehabilitation afterwards.

As in any joint replacement surgery, the ankle implant may loosen or break over time. If this happens, you may need another surgery.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/26/2010…#14595