Column: Managing ankle arthritis

Ankle arthritis is a common condition characterized by chronic, progressive pain in the ankle joint. It is often a result of previous trauma, though can have other causes such as blood clotting or blockage, inflammation, and infection.

While ankle arthritis cannot be cured, effective treatment options exist to help manage symptoms and maintain an active lifestyle. Treatment requires a step-by-step approach, starting with conservative measures and progressing toward surgical options if necessary.

Diagnosis and Conservative Care

The diagnosis of ankle arthritis can typically be made through a weight-bearing x-ray. However, additional diagnostic tools, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) may be required to rule out other causes of ankle pain.

Conservative care is always the first line of treatment and can vary depending on the patient’s activity level, degree of disease, and pain level. Physical therapy, oral or topical anti-inflammatory medications, shoe modifications, orthotics, and injections can all be effective in managing symptoms and improving ankle function.

Injections for Symptom Management
Injections for ankle arthritis serve to alleviate symptoms and often allow improved activity levels. There are different types of injections, including viscosupplements (lubricating injections), steroid injections (anti-inflammatories), and ortho-biologies such as platelet-rich plasma and stem cell injections.

These injections can decrease pain and enhance activity levels, offering relief to patients with more serious diseases who have not responded to other conservative measures.

Braces and Temporary Solutions
For patients who require additional support, a permanent or semi-permanent brace may be recommended. These braces are more involved than those used for sports injuries and can restrict ankle movement, reducing pain.

Patients considering ankle replacement surgery or fusion may trial a motion-limiting brace to assess their ability to perform desired activities post-surgery. Temporary solutions like braces can provide crucial assistance in determining the most appropriate treatment option for each individual.

Surgical Options
In some cases, surgery may be necessary for the management of ankle arthritis. Joint salvage procedures involve realigning the joint to unload areas of stress. If joint salvage is not feasible or has already been attempted without success, joint replacement or fusion surgery may be considered.

It is essential to consult with a foot and ankle orthopedic surgeon to determine the most suitable treatment plan based on individual circumstances.

Dr. Paul Ryan is a board-certified orthopedic surgeon with Tahoe Orthopedics and Sports Medicine. He is a foot and ankle specialist treating patients at three office locations in Carson City, Stateline, and at the Barton Center for Orthopedics & Wellness in South Lake Tahoe, CA. To learn more about foot and ankle services, call 530.543.5554 or visit BartonHealth.org.