| Ankle arthritis is one of the most common problems | | | | surgery 9where the joijt is fused together) often find |
| seen in a rheumatology office. While it is a relatively | | | | rocker bottom shoes helpful. |
| small joint complex, it is subjected to a great deal of | | | | When ankle pain is severe due to inflammation and/or |
| stress because of the weight-bearing required with | | | | fluid accumulation, then aspirating the joint with a needle |
| standing and walking. | | | | and injecting a long-acting glucocorticoid ("steroid") may |
| Throw in the need to make forward and backward | | | | be very useful. Following a procedure like this, it is a |
| movements as well as side to side movements, it | | | | good idea for the patient to have their ankle braced |
| becomes clear that the stress placed on the bones, | | | | for at least three days to rest the joint. |
| ligaments and tendons is tremendous. And that doesn't | | | | Physical therapy is also an excellent adjunctive |
| even account for the twisting and [pivoting motions | | | | therapeutic approach. The therapist can help the |
| that are often required during a typical day. | | | | patient with different modalities that can reduce |
| Because of this responsibility and location, ankles are | | | | edema (soft tissue swelling0 as well as inflammation |
| probably injured more than any other joint complex. | | | | and also teach a patient exercises to strengthen and |
| Many different kinds of arthritis can affect the ankle. | | | | stabilize the ankle so that future ankle sprains and |
| The most common are osteoarthritis. Osteoarthritis is | | | | strains are less likely. |
| a wear and tear type of arthritis. The cartilage that | | | | Patients who have severe ankle arthritis due to |
| cushions the joint begins to wear away prematurely | | | | osteoarthritis may benefit from viscosupplementation. |
| as a result of trauma and localized inflammation. This | | | | This is a procedure where a lubricant is injected into |
| type of osteoarthritis that occurs following injury is | | | | the joint. Viscosupplements have been used |
| referred to as post-traumatic osteoarthritis. A common | | | | successfully in many joints including the knee, hip, and |
| scenario is someone who sprains their ankle as an | | | | shoulder, as well as the ankle. |
| adolescent or young adult and then develops ankle | | | | Surgery is an option for patients who have failed more |
| arthritis years later. | | | | conservative measures. Arthroscopy, which is a |
| Rheumatoid arthritis comprises about 15 per cent of | | | | procedure where a small telescope is inserted into the |
| ankle arthritis. Rheumatoid arthritis is a chronic systemic | | | | ankle joint through a tiny incision. Small instruments are |
| autoimmune disease that affects virtually all joints. The | | | | used to remove loose pieces of cartilage. This |
| chronic inflammation leads to progressive deterioration | | | | procedure can also be incorporated with simultaneous |
| of cartilage, bone, and ligaments. | | | | cartilage transplant where healthy cartilage is inserted |
| Other types of arthritis that can attack the ankle | | | | in place of damaged cartilage at the time of the |
| include psoriatic arthritis, Reiter's disease, gout, | | | | procedure. Cartilage transplant procedures are very |
| pseudogout, sarcoidosis, juvenile arthritis, and ankylosing | | | | time intensive and require limited weight bearing for |
| spondylitis. | | | | several weeks to months afterward. |
| Treatment of ankle arthritis first consists of making the | | | | Joint realignment is a procedure where a wedge of |
| correct diagnosis. That takes a careful history and | | | | bone is removed from one side of the ankle so that |
| physical examination. Laboratory testing and imaging | | | | stress forces are transferred to the healthy part of |
| studies such as x-ray, ultrasound, and magnetic | | | | the ankle. While this is a temporary fix, it is useful for |
| resonance imaging are useful. | | | | some patients. |
| Treatment for mild discomfort is straightforward. Limit | | | | Ankle fusion is a surgical procedure where the tibia (leg |
| activities that cause pain. That means high impact | | | | bone) is screwed to the talus (upper ankle bone). This |
| sports like running, soccer, and basketball. If excess | | | | restores alignment and reduces pain. Unfortunately, the |
| weight is an issue, then weight loss is mandatory. | | | | patient loses about half of the plantar and dorsiflexion |
| Over-the-counter anti-inflammatory medicines can also | | | | (toe down and toe up) movement in the ankle. The |
| provide symptomatic relief. | | | | ability to walk without pain is restored to the ankle; |
| Various ankle braces can be a lifesaver. These come | | | | however, there is more stress placed on other |
| in different varieties and shapes. They can fasten | | | | weight-bearing joints such as the knee, which can lead |
| using laces or Velcro. Braces may be soft or may | | | | to the development of osteoarthritis in these joints. |
| contain a hard synthetic shell. It is best to consult with | | | | Ankle replacement is an increasingly popular option. In |
| your rheumatologist or orthopedist before purchasing a | | | | the past, ankle replacements weren't that effective but |
| brace. | | | | technological advances have improved their success. |
| Orthotics are shoe inserts that tilt the ankle and relieve | | | | Good candidates for ankle replacement are those |
| pain by altering the direction of stress forces. These | | | | who are older than 55 years of age, in good medial |
| should be custom-made for optimal results. | | | | condition, have their weight in the normal range, and |
| Rocker bottom shoes reduce pain with walking | | | | who don't engage in high impact activities either at |
| because they limit the amount of motion the joint has | | | | work or during their leisure time. |
| to go through. People who have had ankle fusion | | | | |