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Ankle osteoarthritis
What is osteoarthritis of the ankle?
The ankle joint is really two joints - a hinge joint that allows the foot to move up and down, and a joint below this that allows the ankle to move from side to side.
In osteoarthritis, the cartilage that lines the joint surfaces becomes worn over time, and this interferes with the smooth movement of the joint.
How do we treat osteoarthritis at the Mansfield Clinic?
Osteoarthritis is a long-term condition which cannot be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are available to reduce the symptoms. Dr Allfree may choose to use one or more of the following treatment strategies to help your joint pain:
- painkilling medication
- a structured supervised exercise plan
- steroid injections into the ankle joints can help
- in osteoarthritis of mild to moderate severity, hyalgan injections into the joint may be beneficial
- In a small number of cases, where the above treatments haven't helped or the damage to the joints is particularly severe, surgical advice may be required, to determine whether joint replacement, or other surgical procedure, is warranted.
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Symptoms of ankle osteoarthritis
As with osteoarthritis in any joint, symptoms include:
- Stiffness
- Pain
- Swelling
As the arthritis progresses, it can be painful to walk or weightbear, especially on uneven surfaces. There may also be pain at rest, and during the night. You may notice that the joint grates or creaks when it moves - this is called crepitus. If the OA is very severe, the bone itself becomes misshapen.
Diagnosis of ankle osteoarthritis
Normally this is an easy diagnosis to make. Dr Allfree will ask you about your pain, and examine your foot and ankle to assess its range of movement. Sometimes an ankle x-ray will be required to determine the extent of the osteoarthritis, and this can be arranged at the Mansfield Clinic.
Treatment of osteoarthritis
Dr Allfree may suggest simple painkilling medication such as paracetamol or ibuprofen, to help relieve the pain and stiffness.
Osteopathic mobilisation techniques and a programme of strengthening exercises can help with mild to moderate osteoarthritis.
If your pain is moderately severe, he may also suggest giving you a steroid injection directly into the joint to relieve pain and inflammation. You will need to avoid strenuous activity and rest for 24 hours after this in order for the steroids to work. Steroid injections do not work indefinitely, and you may find that you will need to have the procedure repeated every so often.
Another option is to inject into the joint with Hyalgan, which is not a steroid. This helps to lubricate the joint.
Surgery
If conservative treatments do not help, it may be necessary to consider seeking the advice of an orthopaedic surgeon who specialises in ankle problems. Dr Allfree will be able to help you with the arrangements. There are a number of different surgical options, depending on the circumstances, and the surgeon will discuss these with you:
- Arthroscopic debridement (a keyhole surgery technique)
- Ankle fusion
- Ankle joint replacement
Self-help
If you have ankle osteoarthritis, there are a number of self-help measures that you can try:
- More supportive footwear can help
- Specialised ankle supports are available
- Gentle non weight bearing exercise such as swimming can help to keep the muscles around the ankle strong, and preserve its range of movement
- You should eat sensibly to keep your weight under control