Understanding Post-Traumatic Ankle Arthritis

Upwards of 15 percent of people diagnosed with osteoarthritis – the most common form of arthritis – are dealing with it in the form of post-traumatic ankle arthritis. The condition can affect people of any age, and it’s actually more common in younger, active individuals in the wake of significant trauma to the ankle. Severe damage to the ankle joint increases your risk of developing arthritis seven-fold, so it pays to be aware of some of the long-term problems that could arise after a significant ankle injury.

Symptoms of post-traumatic ankle arthritis following an injury to your ankles include:

• Dull, chronic pain
• Stiffness
• Difficulty walking
• Reduced flexibility or range of motion
• Discomfort that worsens with activity or pressure

Diagnosing And Treating Post-Traumatic Ankle Arthritis

If you are dealing with any of the above symptoms months or years after a significant ankle injury, consider connecting with a foot and ankle specialist. They’ll conduct a physical assessment of your ankle, talk with you about your symptoms and conduct some imaging tests to get an inside look at the structures inside your ankle joint. If post-traumatic ankle arthritis is suspected, your doctor will walk you through some treatment techniques.

Post-traumatic ankle arthritis is commonly managed through a combination of conservative techniques, including rest, icing, anti-inflammatory medications, physical therapy, and custom bracing or foot orthotics. Doctors may also recommend that you work to lose some weight, as this will take pressure off the arthritic ankle and make movements easier.

Most people notice a decrease in symptoms by following these conservative steps, but if discomfort isn’t getting any better, a more hands-on approach may be recommended. Corticosteroid injections may make it easier to pursue some of the treatments listed above, or a fusion operation can help to limit painful movement inside the ankle joint. It doesn’t typically reach this stage, but it is an option in more severe cases.

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Ankle Arthritis Surgical Options

Here’s a look at three surgical procedures your ankle surgeon may recommend depending on your level of arthritic degeneration.

Surgical Debridement – A debridement procedure is considered for someone with mild to moderation arthritic damage.  An x-ray can help determine how much degeneration has taken place and if bone spurs are in need of removal. The procedure involves cleaning out loose cartilage or bone fragments that can cause joint irritation and damage. A minimally invasive debridement procedure involves making a small incision in the ankle to access the joint and remove any offending pieces or fragments. The procedure is performed under general anesthesia and many patients can return home the same day as surgery with a walking aid like crutches.

Ankle Joint Fusion – For patients with more degeneration, an ankle joint fusion procedure may be in order. Fusing the joint will limit painful movement, helping to eliminate symptoms at the expense of some range of motion. The fusion is performed by using screws or plates to hold the joint in place. After the fusion heals, your doctor may remove the screws or plates used to fix the bones into place, depending on the location of the fusion. The procedure is performed under general or spinal anesthesia, and some patients can leave the same day while others are asked to stay overnight for observation. A splint is typically used for about two weeks before the patient is transitioned to a removable walking boot, and full recovery takes about 3-4 months.

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Common Types Of Ankle Arthritis

There are a number of different types of arthritis that can affect your ankles, so if you’re showing signs or dealing with stiffness or pain in your ankle, set up an appointment with your doctor or a foot specialist so you can begin treating the specific course of ankle arthritis. Here’s a look at a couple different types of arthritis:

Osteoarthritis – Osteoarthritis (OA) is a degenerative form of arthritis where the cartilage that cushions the joint wears away slowly over time. This is a common form of arthritis that can set in due to decades of stress on your ankles and feet. Because of this, it’s most common in individuals over 60 years old, but it can also develop in younger patients as a result of significant trauma to the ankle joint. Treatment can’t reverse this degeneration, but physical therapy and stretching exercises can help to prevent further degeneration and maintain mobility in the ankle joint.

Post-Traumatic Arthritis – PTA, also known as post-traumatic arthritis, is a type of arthritis that sets in after an injury to the ankle joint. It can develop rather quickly after the injury, or it can lead to slow changes over time that eventually turn into symptoms of PTA. Significant sprains, fractures or ankle joint dislocations are the most common reasons for eventual post-traumatic arthritis onset. It is generally treated with stress reduction and weight management alongside over-the-counter medications. If this doesn’t help prevent the onset of the condition, a debridement or reconstruction operation may be required.

Rheumatoid Arthritis – Rheumatoid Arthritis is a different type of arthritis in which the body’s own immune system attacks itself, leading to an inflammatory response in the ankle which can cause pain and inhibited range of motion. Difficulty climbing stairs or inclines can help to signal the early onset of RA. The damage done by rheumatoid arthritis can’t be undone, but certain treatments can help prevent flareups and progression of the condition. Oftentimes treatment involves a combination of exercise, dietary changes and anti-inflammatory medications.

Reactive Arthritis – Reactive arthritis is a chronic form of arthritis that sets in as a complication of an infection, and the ankles are oftentimes one of the first areas affected by the condition. Medications to manage the infection and physical therapy exercises to strengthen the weakened ankle joints are often a very successful treatment combination.

Gout – Gout is a type of arthritis that tends to occur in the big toe joint as a result of high levels of uric acid in the blood, but it can also affect the ankles. Exercise, dietary changes and weight management are all ways to limit the development of uric acid in your bloodstream and in turn reduce gout flareups.

If you’re dealing with any of these types of ankle arthritis, be sure to set up an appointment with Dr. Silverman’s office today.

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Causes and Symptoms of Ankle Arthritis

Natural cartilage degeneration isn’t the only way that arthritis of the ankle sets in. Ankle injuries also play a direct role in the onset of the condition, and roughly 80 percent of people who have ankle arthritis say they’ve suffered one or more ankle fractures or sprains in the past. Other forms of arthritis, like rheumatoid and psoriatic arthritis, also contribute to cartilage breakdown in the ankle.

Symptoms of the condition include:

• Pain
• Stiffness
• Difficulty walking/Inhibited gait
• Joint swelling
• Ankle tenderness

Diagnosing and Treating Ankle Arthritis

If you are experiencing any or all of the above symptoms, head into your foot specialist’s office. The diagnostic process is pretty straightforward, with the doctor asking about your symptoms and then conducting a physical examination of the foot. They also may ask you to perform some range of motion exercises to see what movements are tolerable. From there, they will confirm the diagnosis with an imaging test.

X-rays are the most common imaging test, because they allow the doctor to see the narrowing of the space between bones, as well as to view the onset of any bone spurs that may be damaging cartilage or making movements painful. For a more precise diagnosis, a doctor may use an MRI or CT scan, but X-rays typically suffice.

Although there is no cure to reverse the damage done by arthritis, there are treatments to prevent further degeneration and alleviate symptoms. If degeneration is in its earliest stages, non-operative treatments are usually the most effective route, but if damage is severe, then surgery may be on the table.

Nonsurgical Treatment Options – Changing exercise routines to activities like swimming or cycling that put less stress on your feet, physical therapy and range of motion exercises, ankle braces, anti-inflammatory medications and cortisone injections can all help in the short-term.

Surgical Treatment Options – Arthroscopic debridement surgery can remove loose cartilage or bone spurs around the joint. For others with more severe joint dysfunction, an ankle fusion procedure can help fix the joint in a permanent position to prevent pain and discomfort from movement. There is also the total ankle replacement operation, which involves inserting an artificial joint, similar to a hip or knee replacement.

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