Introduction
Arthritis is a common medical condition in which the joints are inflamed. It causes pain, joint stiffness, and reduced mobility of the joint. Arthritis can affect any joint of the body. However, the ankle and foot are the common joints affected. A person with ankle arthritis may struggle to walk and enjoy daily activities. Several conservative treatments play an important role in managing the condition at early stages. Surgical intervention is necessary for people with advanced stages of ankle arthritis. During surgery, the total ankle is replaced to restore mobility.
What Is Ankle Arthritis?
Ankle arthritis is when the person’s ankle joint is inflamed and degenerated. The cartilage covers the ends of the ankle and protects the joint from trauma. Several bone diseases, such as osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis, may start the degenerative process. The wearing away of protective cartilage causes the rubbing of bones against each other. This may lead to pain, stiffness, and diminished joint mobility. The person with the condition may be unable to perform everyday activities. Both surgical and non-surgical interventions are used to manage the symptoms and improve joint functions.
What Are the Causes of Ankle Arthritis?
The common causes of ankle arthritis are as follows:
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Osteoarthritis: It is the common cause of ankle arthritis. With an increase in age, there is wear and tear of the joints, leading to the development of the condition.
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Rheumatoid Arthritis: It is a common bone disease affecting many people. The synovial membrane gets inflamed, leading to loss of cartilage and joint damage.
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Post-traumatic Arthritis: Any injury or trauma to the ankle may lead to dislocations, fractures, and sprains. With time, it may lead to the development of post-traumatic arthritis.
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Inflammatory Arthritis: Some inflammatory diseases, such as systemic lupus erythematosus (a condition in which the immune system damages its cells), can contribute to the inflammation of the joints.
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Gout: The uric acid crystals accumulate in the joints, such as the ankle, leading to the development of ankle arthritis.
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Genetic Factors: An individual with a family history of arthritis may tend to develop ankle arthritis.
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Occupational Factors: An individual doing a job that causes repetitive pressure on the ankle joint may contribute to the development of ankle arthritis.
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Obesity: An individual with excessive weight may have additional stress on the ankles, leading to cartilage degeneration. This can contribute to the development of ankle arthritis.
What Are the Signs and Symptoms of Ankle Arthritis?
The signs and symptoms of ankle arthritis are as follows:
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Persistent severe and throbbing pain around the ankle joint.
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Reduced joint flexibility.
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Swelling around the ankle joint.
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Increased sensitivity and tenderness on the ankle joint on applying pressure.
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Limited range of motion, which may impact walking and climbing.
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An individual may experience a clicking sound.
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Increased warmth around the ankle joint.
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Change in the alignment of the foot.
How Is Ankle Arthritis Diagnosed?
An experienced healthcare professional diagnoses ankle arthritis. The orthopedician may ask the patient about any previous injuries to the joint or a family history of arthritis. On physical examination, the ankle joint will be assessed for signs of arthritis, such as pain, tenderness, swelling, and limited range of motion. Imaging studies, such as X-rays and magnetic resonance imaging (MRI), are done to diagnose the condition. An X-ray is used to check the structures of the joints. Any joint space narrowing may indicate the presence of the condition. An MRI is to provide detailed images of the cartilage within the ankle joint. The joint aspiration is conducted to rule out the cause of the condition.
What Is the Surgical Treatment of Ankle Arthritis?
Surgical treatment of ankle arthritis is suggested to alleviate pain and improve joint mobility and joint function. However, the surgical treatment is based on certain factors, such as patient health, joint damage severity, and joint inflammation severity. The common surgical treatments for ankle arthritis are as follows:
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Arthroscopic Debridement: It is a common surgical procedure to manage the condition. During this surgical procedure, the camera (arthroscope) is used to see the joint's interior. It is advised only when medications and physical therapy do not provide much relief. Under general anesthesia, a small incision of half an inch size is given around the ankle joint. The camera is inserted into the incision area. The inflamed tissue, such as damaged cartilage, is removed. The fresh sterile solution is flushed to remove debris. The incision is closed with sutures. The patient can often return on the same day. A person can resume their daily activities within a few days to weeks. The procedure is minimally invasive and provides a faster recovery.
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Ankle Fusion: The other name of ankle fusion is arthrodesis. The ankle joint is permanently fixed. Under general anesthesia, a small incision is made over the ankle area. The damaged cartilage is removed. The underlying bone is exposed and prepared to remove the remaining cartilage. The exposed bone is roughened and ready for fusion. The ankle bones are repositioned to promote fusion. The bones are fused by using screws, rods, and plates. In some cases, the fusion process is enhanced by using bone grafts. Bandages are applied, and an incision is closed. After surgery, the patient may use a walker to immobilize the ankle. The patient may take several weeks to months to recover.
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Total Ankle Replacement: The other name of total ankle replacement is total ankle arthroplasty. Under general anesthesia, the incision is made over the ankle. The damaged arthritic part is removed and the artificial joint is secured by using metals or plastics. The incision is closed, and bandages are applied. During the initial recovery period, the patient may use crutches for support. The patient is advised to physical therapy to regain flexibility and balance.
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Joint Distraction: The other name of joint distraction is joint unloading. It is recommended to manage severe ankle arthritis. The external fixator device is applied externally to the ankle joint. It distracts or separates the joint surfaces slightly. The device reduces the mechanical load on the damaged cartilage by creating a gap between the joint surfaces. The treatment may take several weeks to months. The patient may use assistive devices, such as crutches, to reduce weight. The patient is regularly monitored to assess the changes in the joint space.
Conclusion
In conclusion, surgical intervention is recommended to reduce pain and stiffness and improve joint mobility. The decision on the type of surgical intervention is based on the fracture's type and severity. For informed decision-making, the person should understand the risks and benefits of the surgical intervention. They should consult with the healthcare professional or orthopedic specialists for personalized guidance.
