What is Arthritis?

Arthritis is a medical condition which affects the body’s joints and is a major cause of debilitating pain and disability for many people. In fact, up to 32.9 million American adults reported being told by a physician that they have some type of arthritis.

There are more than 100 types of arthritis. But, the most common form is osteoarthritis, which develops as we age. In this condition, the thin cartilage covering on the ends of the bones becomes worn and frayed, resulting in inflammation, swelling and pain. It affects nearly 16 million Americans, most of whom are 45 and older.

Arthritis can also occur following injury to a joint. This is known as traumatic arthritis. It may develop months or years after a severe sprain, torn ligament or broken bone.

Rheumatoid arthritis is a systemic disease in which the immune system turns against itself. Instead of protecting the joints, the body produces substances that attack and inflame the joints. Rheumatoid arthritis affects 2.1 million Americans, including children and adults. It most commonly occurs in the hands and feet.

This web site will focus on arthritis of the ankle and foot. Click on the links below to learn more about how arthritis affects the joints of the foot and ankle, and what treatment options are available.

Symptoms of Ankle arthritis

Learn the most common symptoms associated with this condition.

 Wheeless' Textbook of Orthopaedics
 Arthritis Foundation
 WebMD (Arthritis)

The Foot and Ankle Contain:

26 Individual Bones 33 Joints Ligaments More than 100 Muscles

Tendons Blood Vessels Nerves Skin & Tissue

All these foot components combine to provide the body with support, balance, and mobility.

Diagnosing Arthritis of the Foot and Ankle

Ankle arthritis is diagnosed through a combination of reviewing the symptoms, physical examination and x-rays or other imaging tests.

During your visit, your doctor may ask you a series of questions¹ such as:

• When did the pain start? Is it worse at night? Does it get worse when you walk or run? Is it continuous or does it come and go?
• Have you ever had an injury to your foot or ankle? What kind of injury? When did it occur? How was it treated?
• Is the pain in both feet or just one? Where is the pain centered?
• How active is your lifestyle? What kinds of shoes do you normally wear? Are you taking any medications?

As part of your exam, your doctor may also suggest a gait analysis. This detailed study of how you walk identifies the positions of the bones in your leg and foot as you move, measures your stride and tests the strength of your ankles and feet.

In addition to a physical exam, your doctor may order x-rays or special imaging tests such as a bone scan, computed tomography (CT) scan, or magnetic resonance image (MRI) to determine the extent of damage to the joint.

If rheumatoid arthritis (RA) is suspected, blood tests will show whether you are anemic or have an antibody called the rheumatoid factor, which is often present with RA.

¹American Academy of Orthopedic Surgeons

Treating Your Arthritis

Depending on the type, location and severity of your arthritis, there are both non-surgical and surgical treatment options available.

Non-Surgical Options

These conservative techniques are often used to treat early stage or non-severe arthritis.

Weight Control – for many patients weight loss is very helpful and should be a cornerstone of the treatment strategy. Scientists estimate that for each pound lost, stress on the ankle is reduced by five pounds.

Pain medication – often doctors will prescribe non-steroidal anti-inflammatory drugs to reduce swelling and help relieve pain.

Nutritional Supplements – Glucosamine hydrochloride and chondroitin sulfate are nutritional supplements which help to conserve the remaining joint cartilage.

Shoes and inserts – pads, arch supports or even custom-made stiff-soled shoes with rocker bottoms can help make walking more comfortable.

AFO- ankle-foot arthosis - A brace (usually plastic) worn on the lower leg and foot to support the ankle, hold the foot and ankle in the correct position, and correct foot-drop.

Physical therapy and exercise

Injections – symptoms can be markedly improved by the injection of a steroid into the joint. However, this can have a negative long-term effect on the joint.

Surgical Options

If arthritis does not respond to the conservative non-surgical treatments, surgery may be an option.

An average of 30,000 U.S. patients undergo ankle surgery each year. The decision to treat ankle arthritis surgically is based on many factors including:

• The location of the cartilage loss in the ankle
• Patient age, weight and expected activity level
• Condition of the skin, nerves, tendons and bone around the ankle
• Response to previous treatment
• Other medical problems

The primary surgeries performed for arthritis of the ankle are:

Arthroscopic debridement. Helpful in the early stages of arthritis development, this procedure involves insertion of a pencil-sized camera and small instruments into the joint to visualize and remove foreign tissue and bony outgrowths (spurs).

Arthrodesis, or fusion. Ankle fusion is the most common surgical technique performed today. This procedure eliminates the joint by encouraging the bones to grow together. During the process, the cartilage is removed, and the bones are pinned together with screws, plates, rods or pins to hold them in position while the bones eventually grow together into one solid mass.

Arthroplasty, or joint replacement. First implemented in the 1970’s, arthroplasty, or total ankle replacement involves resurfacing the ankle joint with mechanical parts that allow continued motion and function without pain.