The foot and ankle are complex structures used in nearly every form of human movement. They provide support, shock absorption, and balance. There are three bones that make up the ankle joint: the tibia, fibula, and talus. The ankle joint allows the foot to flex and extend. There are a total of 28 bones in the foot, and more than 30 joints that allow for a wide range of movement. Tough bands of tissue called ligaments are located on either side of the ankle joint to provide stability. Muscles and tendons are also located throughout the foot to allow for motion and to support the joints.
Cartilage covers the ends of the bones, allowing the bones to glide smoothly during movement. Loss of the cartilage due to arthritis can produce pain, stiffness, and swelling. When the bones begin to grind on each other it can result in constant pain during standing or walking, and loss of mobility.
There are three common forms of arthritis that affect the ankle joint. Osteoarthritis is common in older adults. It is also known as degenerative or “wear and tear” arthritis. The protective cartilage wears away over time, resulting in bone rubbing on bone and ankle pain. Rheumatoid arthritis is an autoimmune disease where the immune cells attack the joint lining. It can also attack the ligaments and tendons and cause serious joint disability. Posttraumatic arthritis often occurs after an injury to the foot or ankle, such as motor vehicle accident or sports injury.
Ankle arthritis symptoms can include one or more of the following:
- Swelling and tenderness
- Increased pain with movement, in the morning, or after sitting
- Pain flares up with activity
- Difficulty in walking
Diagnosis and Treatment
Your orthopedic surgeon will examine your foot and ankle for swelling and tenderness, do a gait analysis, and ask about your medical history. Generally, x-rays are taken to provide a detailed picture of your foot and ankle structure. There is no cure for arthritis, but treatments are designed to relieve pain and restore motion.
Nonsurgical treatments include modifying your lifestyle, physical therapy, braces, orthotics, and non-steroidal anti-inflammatories (NSAIDS). If your pain is not relieved with conservative treatments, your doctor may recommend a total ankle replacement.
Total Ankle Replacement
Ankle replacements offer patients more mobility than fusion and relieves the pain of arthritis. The prostheses is modeled after human anatomy and helps to reproduce natural movement of the ankle. Your orthopedic surgeon will make an incision on the front of the ankle. The diseased cartilage and bone are then removed from the tibia and talus. Lastly, a metal and plastic implant is inserted. Sometimes additional procedures are performed depending on the extent of your arthritis and ankle injuries.
Full recovery can take from 6-12 months, but most people can resume daily activities within two weeks. Your movement will be restricted for 6-8 weeks, and then you will start physical therapy to restore strength and range of motion. Your doctor will advise you on other restrictions depending on your lifestyle and goals.
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