FOOT & ANKLE

Foot & Ankle Arthritis

Foot and ankle arthritis is a degenerative condition which is usually a result of previous trauma to the region. It can also be the result of auto-immune or inflammatory conditions. It results in pain, swelling and restriction in range of motion and often a deformity. The joints of the ankle, midfoot and big toe are commonly affected by arthritis.

There are three types of arthritis affecting the foot and ankle.

Osteoarthritis: Also called degenerative joint disease, is the most common type of arthritis, occurring most often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, called a bone spur.

Rheumatoid Arthritis: An auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, and loss of function in joints. Rheumatoid Arthritis affects mostly joints of the hands and feet and tends to affect the same joints on both sides of the body at the same time and with the same symptoms.

Post-traumatic Arthritis: Arthritis developing following an injury to ankle or foot. The condition may develop years after the trauma such as a fracture, severe sprain, or ligament tear.

Symptoms

Symptoms of foot and ankle arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed and pain develops gradually over time.

Other symptoms include:

Pain with motion
Increase in pain with vigorous activity
Tenderness with pressure to the joint
Swelling, warmth and redness

Causes

The causes of foot and ankle arthritis depend on the type you are diagnosed with. Arthritis can develop due to fracture, dislocation, inflammatory disease or congenital deformity.

Diagnosis

Diagnosis is made by medical consultation and examination, taking the patient's past medical history and confirmed by x-ray of the affected area. Sometimes an MRI or CT scan may be offered, this can help determine whether pain is being impacted by other areas of the foot and ankle.

Treatment Options

Non Operative Treatment

As with arthritis of the hip and knee, first line treatment is non-operative and consists of a range of options.

Pain killers (paracetomol or panadol osteo) and anti-inflammatories if tolerated and not contraindicated
Physical therapy to help increase range of motion, flexibility and strengthen muscles in the foot and ankle
Assistive devices such as an ankle foot orthosis (AFO) to help improve mobility, orthotics (shoe inserts) or custom made shoes with stiff soles to minimise pressure on the foot and decrease pain.
Lifestyle modifications to manage pain and slow progression such as weight loss to decrease pressure on the joints, minimise aggravating activities and change to low impact activities.

Surgery

Following consultation and review, if arthritis has progressed and other interventions have not succeeded, surgical intervention for treatment may be recommended. As with all surgeries, it comes with some risks and should be left as a last resort.

Arthroscopy

Arthroscopy may be helpful in the early stages of foot and ankle arthritis to remove loose cartilage, inflamed synovial tissue and bone spurs around the joint. Surgery is minimally invasive, keyhole surgery that involves inserting a small telescope (arthroscope) to help diagnosis and/or treatment.

Find out more about Ankle Arthroscopy.

Ankle Fusion Surgery

Ankle Fusion Surgery, also known as ankle arthrodesis, is a procedure to fuse the bones of the ankle joint. It is performed as an

arthroscopy procedure which is minimally invasive and involves removal of remaining cartilage from the ankle joint surfaces and the use of large screws to fuse the bones together.

Find out more about Ankle Fusion Surgery.

Total Ankle Replacement

During total ankle replacement the damaged cartilage and bone is removed and replaced with metal and plastic implants to allow for a smooth functioning ankle joint. It is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis or post-traumatic arthritis. The goal of ankle replacement is to relieve pain and restore the normal function of the ankle joint.

Find out more about Total Ankle Replacement.