Joint, Ligament and Muscle Disorders

Ankle Arthritis

Anatomy

The ankle joint connects the leg and the foot. It is formed by three separate bones, the tibia, fibula and talus. The shinbone (tibia) supports most of a person's weight when standing. The outer bone (fibula) is the smaller bone of the lower leg. A small, irregular-shaped foot bone (talus) connects the tibia and fibula. Acting as a hinge, these bones form the ankle. The ankle joint allows movement such as walking, running and jumping, and also contributes to lower limb stability.

The ankle is reinforced by fibrous tissue (ligaments) that connects bone to bone. Ligaments have an elastic structure that allows them to stretch, within their limits, and then return to their normal positions. Ligaments protect the ankle from abnormal movements-especially twisting, turning and rolling of the foot.

Description

Arthritis is inflammation that can cause pain and stiffness in any joint in the body. Osteoarthritis, also known as degenerative or "wear-and-tear" arthritis, is a common problem for many people after reaching middle age. It is often experienced in the small joints of the foot and ankle. In osteoarthritis, the cartilage in the joint gradually wears away, becoming frayed and rough. As protective space between the bones decreases, it can result in bone rubbing on bone, causing painful osteophytes (bone spurs).

Nonsurgical Treatment

Your physician may suggest changes in your daily lifestyle that can help relieve the pain of arthritis and slow the progression of the disease. If appropriate, a foot and ankle conditioning program may be recommended.

Surgery

If your pain causes disability and is not relieved by nonsurgical treatment, surgery may be recommended. The appropriate surgery will depend on the type and location of the arthritis and the impact of the disease on your joints. In some cases, more than one type of surgery may be recommended.

• Arthroscopic debridement—This may be helpful in the early stages of arthritis. Debridement (cleansing) is a procedure to remove loose cartilage, inflamed synovial tissue, and bone spurs from around the joint. Arthroscopic surgery is most effective when pain is due to contact between bone spurs and the arthritis has not yet caused significant narrowing of the joint space between the bones. Arthroscopy can make an arthritic joint deteriorate more rapidly because removing bone spurs may increase motion in the joint, causing the cartilage to wear away quicker.
• Arthrodesis (fusion)—The goal of the procedure is to reduce pain by eliminating motion in the arthritic joint. During arthrodesis, the doctor removes the damaged cartilage and then uses pins, plates and screws, or rods to fix the joint in a permanent position. Over time, the bones of the joint fuse completely, or grow together, making one continuous bone out of two or more bones-just as two ends of a broken bone grow together as it heals. By removing the arthritic joint, the pain disappears.
• Total ankle replacement (arthroplasty)—During this procedure, your orthopaedic surgeon removes the damaged cartilage and bone, and then positions new metal or plastic joint surfaces to restore the function of the joint.

With any surgery there are some risks, and these vary from person to person. Complications are typically minor, treatable and unlikely to affect your final outcome. Your orthopaedic surgeon will speak to you prior to surgery to explain any potential risks and complications that may be associated with your procedure.