Ankle Arthritis.
Edited By: Bruce J. Sangeorzan, M.D.
Last updated Wednesday, August 06, 2008
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Management and treatmentTreatment There are many steps in the treatment of arthritis. The first step is
weight reduction and activity modification. Weight reduction is helpful
because excess weight causes a magnified increase in weight on the
small ankle joint. Activity modification is helpful if specific
activities cause the symptoms. If these steps are not helpful,
over-the-counter analgesic medications such as acetaminophen are used.
The next step is bracing and then use of non-steroidal
anti-inflammatory medications. When these are no longer successful,
surgery may be indicated. Surgical treatment options range from
minimally invasive surgery up to and including an ankle replacement or
ankle arthrodesis.Self-management Weight reduction and regular low-level exercise that does not stress the joint are the key components of self-management.Health care team The health care team for ankle arthritis usually includes a primary
care physician, physical therapists, an arthritis specialist and an
orthopedic surgeon.Pain and fatigue Pain from ankle arthritis is managed with weight reduction, activity
modification, analgesic medications, bracing and sometimes surgery. The
steps that reduce pain may also reduce the sense of fatigue and
accompanies the pain.Diet The role of diet in treatment of arthritis is controversial. There
is no proven dietary pathway that will reduce active arthritis.
Nonetheless a healthy diet that contributes to overall good health will
play a positive role in the management of arthritis. In addition,
weight reduction is very helpful in the management of ankle arthritis.
Because the ankle is a small joint, weight is concentrated in the ankle
joint. Small decreases in body weight can have a magnified impact on
reduction of symptoms in ankle arthritis.
Exercise and therapy Exercise and therapy may be helpful particularly in the early stages
of ankle arthritis. Rest is common and successful method of reducing
symptoms. Unfortunately, resting the ankle requires reduction in
walking, standing and running. Swimming and cycling may be
well-tolerated.
Medications First-line medication for arthritis of the ankle is similar to that for
the hip and knee. Acetaminophen is the first medication employed. A
physician may recommend aspirin and NSAIDs such as naproxen and ibuprofen as well. For more severe types of arthritis, other medications may be employed.Surgery Surgery may be very successful in the treatment of pain and swelling of
ankle arthritis. In arthritis that affects only a small part of the
joint, surgery may be used to replace a damaged cartilage using
cartilage from another part of the body. If arthritis involves the
entire ankle, surgery may be helpful to remove painful areas. When
arthritis is advanced, ankle replacement with an artificial joint or
ankle arthrodesis (fusion) may be used. Arthrodesis is successful and
durable but makes the joint permanently fixed. In other words, the
joint no longer moves.Joint aspiration Removing fluid from the joint with fine needle aspiration may be
helpful in diagnosis and may be slightly helpful in treatment.
Injection of medication into the joint may be employed a maximum of two
times any given joint. Medication placed into the joint by this method
may provide symptom relief for up to a few months.
Splints or braces Braces and splints are helpful in managing ankle arthritis; the more
severe the arthritis, the more rigid the brace. Braces may range from
soft lace-up braces to hard plastic boots. The brace or splint will
limit the motion of the joint and offload some of its stress.Long-term management In the early phases of arthritis, monitoring symptoms is necessary.
As the symptoms become more severe periodic x-ray evaluation may be
helpful.
Surgery for Ankle Arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-731-4830 to make an appointment. Our clinical center is located in Seattle Washington, USA
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