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Non-operative management of ankle arthritis can often be very successful for long periods of time before surgical intervention becomes necessary. Some patients do well for many years with these modalities.
Ankle arthritis is a progressive wearing of the cartilage of the ankle or tibiotalar joint. It encompasses a wide range of severity. It is most commonly caused by prior injuries to the joint but there are many other causes including infection, rheumatoid arthritis, avascular necrosis, and congenital or hereditary factors. As the joint becomes more involved, it can eventually get to the point where the cartilage, which normally cushions the joint, becomes completely worn thin and a “bone on bone” situation is present.
Pain is usually mechanical in nature. This means that activity and weight bearing exacerbate the symptoms. The pain is usually achy in nature and is worse at the end of a long day of activities. The range of motion of the ankle joint may become decreased as the arthritis progresses and patients often complain of stiffness. Bone spurs can often form on the periphery of the joint which can cause symptoms as well.
Conservative or non-operative management can often be very successful for long periods of time before surgical intervention becomes necessary. These modalities include wearing a brace, anti-inflammatory medications, ice, activity modification, rocker bottom shoes, and steroid injections. Some patients do well for many years with these modalities. When surgery is considered, there are several options. Often, a surgery to remove the bone spurs can relieve symptoms and increase range of motion of the joint. Following this surgery, all of the above mentioned non-surgical interventions can be added to the treatment regimen if needed over time. Once these interventions have been exhausted, there are 2 main surgical treatments available. These include fusion of the ankle joint and ankle joint replacement (arthroplasty). The decision as to which is best for each particular patient depends on many factors including age, activity level, type of arthritis, and amount of deformity. Your surgeon will discuss recommendations based on these individualized patient factors. Austin Ankle Associates has extensive experience in these treatment options. Dr Mark Ray Dalton performed the first ankle replacement surgery in Austin in 2006. He has vast experience with this surgery and is proficient with many different types of ankle replacement implants.