Ankle arthritis is less common than arthritis in other joints in the body, but for many, growing pain with a loss of motion in the ankle can make day-to-day life difficult and many activities impossible.
Typically ankle arthritis pain can be traced back to rheumatoid arthritis or osteoarthritis. Rheumatoid arthritis is a disease that causes the body’s immune system to attack joint tissue, causing swelling, loss of movement and over time wearing of the cartilage between bones, then damage to the bones themselves.
Osteoarthritis, or degenerative joint disease, is a wear-and-tear arthritis in which the cartilage between the bones wears down over years of stress and activity. The breakdown of cartilage leads to greater friction, more joint pain, and with the loss of that protective layer, more damage to the joint.
The ankle is unique among joints for being at risk of post-traumatic arthritis. Post-traumatic arthritis is a long-term condition sparked by an acute injury or series of injuries. Although bones and tissue may heal from a fracture or severe sprain, the parts of the joint may remain out of alignment, causing friction and eventually, degradation of the joint.
Post-traumatic arthritis accounts for over half of all cases of ankle arthritis. It is more common among younger, active people, and while osteoarthritis often causes a general pain and stiffness in the joint and the surrounding area, post-traumatic arthritis often causes a specifically located pain.
Symptoms of post-traumatic arthritis can include:
- Painful incidents of the joint giving out
- Changed gait when walking
- Severe loss of function
Typically, your Orthopedic surgeon will offer non-surgical treatment options first. If these treatments do not adequately relieve the symptoms of ankle arthritis pain, your Orthopedic surgeon may discuss whether you are a good candidate for ankle surgery such as total ankle replacement surgery or joint fusion surgery.
Ankle Joint Fusion Surgery
There are several variations of ankle fusion surgery, or arthrodesis, which can be performed as open surgery or as an arthroscopic procedure. Many Orthopedic surgeons prefer using an arthroscopic method to minimize incisions and blood loss, while allowing for shorter recovery time.
In either case, the patient is often given general anesthesia and will sleep through the surgery. The Orthopedic surgeon will then make an incision at the heel and begin the procedure by cleaning the area around the joint, removing tissue debris and bone spurs, and trimming damaged and frayed cartilage.
Articular cartilage is removed from the area between the two sections of the ankle joint, with healthy bone exposed. The two parts are then aligned and fixed together with screws. The exposed bone allows the separate parts of the ankle to heal together as a single bone, like a bone healing from a fracture.
The screws usually remain in the ankle unless an issue of pain or irritation presents itself following surgery.
After surgery, your foot is often wrapped for about two weeks, after which, you are given a short-leg cast.
During recovery, your foot and ankle cannot bear weight until the separate parts of the ankle begin to heal together, which may take between eight and 12 weeks.
When your ankle is fully healed you can expect to return to most of your previous activity without complication. Most patients recover and are able to walk without any visible difference in gait or permanent limp, although the fused joint often affects a person’s gait when running.