Your morning walks are painful, and you’ve noticed swelling and warmth around the ankle. The pain has gradually increased to the point of severely limiting your activities. Your doctor suspects arthritis in the ankle and referred you to an orthopedic specialist. What happens next?
According to Jeffrey Johnson, MD, Washington University orthopedic surgeon, “Arthritis is inflammation of one or more of your joints that can eventually lead to thinning or loss of joint cartilage. The major types of arthritis that affect the foot and ankle are osteoarthritis and rheumatoid arthritis.
Although there is no cure for arthritis, there are a number of surgical and nonsurgical treatment options available to slow the progression of the disease and relieve the pain and symptoms it causes.”
Symptoms of arthritis can vary, but in many cases an ankle joint affected by arthritis will be painful and often inflamed. There can be tenderness when pressure is applied, pain with motion and pain that flares up with vigorous activity or walking. Increased pain is common in the morning or after a period of sitting, called “start-up pain.”
If the orthopedic specialist does confirm arthritis through a physical evaluation and imaging, there are several treatment options available.
Nonsurgical treatment
- Lifestyle modifications/weight reduction
- Low-impact fitness activities (swimming, water exercise, elliptical trainer, biking)
- Anti-inflammatory medications
- Steroid injections
- Bracing/orthotics
Surgical treatment for mild to moderate arthritis
Ankle arthroscopy is a procedure to improve ankle joint function by using a small arthroscope to remove bone spurs, loose pieces of cartilage or scar tissue.
Ankle osteotomy is a realignment procedure that cuts the bones of the leg, ankle or foot to change the weight-bearing stresses on the arthritic ankle cartilage. This realignment shifts the body weight to the healthy portion of the ankle cartilage.
Surgical treatment for severe endstage arthritis
Ankle fusion improves function and reduces pain by fusing the ankle bones into one bone to eliminate motion in the the arthritic joint.
Total ankle replacement involves replacing the cartilage surfaces of the ankle in order to maintain some range of motion in the ankle joint. The procedure also may protect other joints around the ankle from developing arthritis.
Dr. Johnson explains, “After any of these surgical procedures, our patients are carefully observed with follow-up appointments and imaging of the ankle joint. A comprehensive physical therapy program begins after the bones and soft tissues have healed sufficiently – usually 6-10 weeks following surgery.
Depending on what type of ankle surgery was performed, daily activities can be resumed within three to five months, but a full recovery can take up to one year.”
To make an appointment in the division of foot and ankle surgery, or with any other Washington University orthopedic specialist, please call 314-514-3500.
Orthopedic Surgery Center
Center for Advanced Medicine
4921 Parkview Place, Suite 6A
St. Louis, MO 63110
Washington University and Barnes-Jewish Orthopedic Center
14532 S. Outer 40 Drive
Chesterfield, MO 63017
Center for Advanced Medicine – South County
5201 Midamerica Plaza
St. Louis, MO 63129