What is Ankle Osteoarthritis?
In today’s competitive world, a person has to be on his heels an awful lot to keep pace with the times. This leads to increased pressure on the various joints, muscles, and bones in our body. As we grow, this increase in the wear and tear on different parts of the body increases causing considerable damage to the bones and joints. This leads to a condition called as Osteoarthritis. Osteoarthritis can occur in any joint of the body but since the foot is the most used part of the body it is mostly seen in the knee and ankles. Ankle Osteoarthritis is one such condition in which the ankle joints get damaged due to increasing pressure and passage of time.
Ankle Osteoarthritis can cause severe pain, swelling in the ankle and in some cases visible deformity. Ankle Osteoarthritis is an age related condition and usually starts in the mid 40s. This is when the ankle starts to act up as the cartilage tissues start to break down causing severe pain, swelling, and deformity in the ankle. With passage of time, the tissues keep deteriorating and the bones lose their covering thereby rubbing against each other causing incapacitating ankle pain.
What are the Causes of Ankle Osteoarthritis?
Ankle Osteoarthritis is a degenerative condition. An individual with a family history of Osteoarthritis may also have this condition at some point in their life. Age is also a factor as stated above in development of Ankle Osteoarthritis. The more a person is on his or her foot, like someone working as a greeter or a long distance truck driver over a period of time the ankles will start acting up leading to Ankle Osteoarthritis.
A traumatic injury to the ankle may also cause Ankle Osteoarthritis. This condition is called as Posttraumatic Ankle Osteoarthritis. The condition may develop long after the individual has had the injury and also has had appropriate treatment for it. Trauma to the ankle can be caused due to various reasons like an object falling on the ankle, a motorcycle accident where the individual sustains an inversion or a twisting injury to the ankle, which even after being treated after several years may lead to Ankle Osteoarthritis.
What are the Symptoms of Ankle Osteoarthritis?
If an individual has Ankle Osteoarthritis, then he or she will have symptoms of pain and tenderness at the ankle. There will also be symptoms and signs of reduced and painful range of motion of the ankle. The individual will have difficulty putting weight on the affected ankle. Ambulation may also become tougher. Ankle Osteoarthritis can also cause the joints to become stiff. All these symptoms clearly point to Ankle Osteoarthritis.
How is Ankle Osteoarthritis Diagnosed?
A patient with symptoms of Ankle Osteoarthritis will first be evaluated by an orthopedic physician. The physician will conduct a detailed history taking asking as to when the symptoms started, has there been any trauma to this area at present or in the remote past, and of there is a family history of osteoarthritis. The next step towards diagnosis will be a physical examination of the affected ankle, which will clearly show swelling and pain in the area. There may also be a visible deformity. The physician will conduct a range of motion test to see how far the ankle can move without reproduction of pain. The physician will then recommend imaging studies in the form of x-ray and MRI scans to look at the internal structures of the ankle which will confirmatively diagnose Ankle Osteoarthritis.
What is the Treatment for Ankle Osteoarthritis?
Osteoarthritis these days is quite a common condition and with the advancement that medical science has made there are numerous treatment options available for treating Ankle Osteoarthritis. These treatments can be both conservative as well as surgical depending on the extent of damage that has been caused to the tissues, ligaments, and bone by Ankle Osteoarthritis. The treating physician will come up with the best course of action for the patient looking at the overall health of the patient, comorbidities, age, and other such factors.
Nonsurgical Treatments for Ankle Osteoarthritis:
This form of approach is used for generally those individuals who either cannot have surgery or have a very mild form of Ankle Osteoarthritis which can be controlled with this approach. This approach consists of calming down inflammation and pain associated with ankle osteoarthritis with use of NSAIDs or pain medication, activity modification so that there is not much pressure put on the affected ankle. Plenty of rest and in some cases taking some days off of work if the patient works at a job where he or she has to stand for prolonged periods of time or drive for long distances frequently is recommended. In some cases, job modification or change is also suggested.
Steroid injections are also an option for pain relief, although it has not shown much promise in treating Ankle Osteoarthritis. Application of heat and ice is also one of the modes of treatment of Ankle Osteoarthritis. Ice can be applied to the affected ankle 15 to 20 minutes two to three times a day to calm down inflammation and pain. It should be made sure that ice should not be applied directly to the skin as it may result in development of blisters. Heat pads are also quite effective in calming down inflammation and improving pain caused due to Ankle Osteoarthritis.
Apart from this, the physician may also recommend physical therapy as a mode of treatment of Ankle Osteoarthritis. Physical therapy will help the patient make the ankle stable, increase the strength of the ankle, and improve range of motion of the ankle.
Based on the extent of damage to the ankle, the patient may be recommended use of walker, crutches, or shoe inserts to offload the pressure from the ankle. The shoe inserts, orthotics, or braces can be either recommended by the physician or can be brought over the counter from the pharmacy. Managing ones weight can also help relieve pain and inflammation of the ankle, as more the patient is overweight the more pressure is put on the ankle.
Surgical Treatment for Ankle Osteoarthritis:
Surgical treatment for Ankle Osteoarthritis is only recommended in cases where there has been considerable damage to the ligaments and tissues of the ankle due to the osteoarthritis and conservative approach is not effective. There are many surgical procedures for treating Ankle Osteoarthritis and depending on the health of the patient, the age, and comorbidities the surgeon will come up with the most optimal surgery to treat Ankle Osteoarthritis. Some of the surgical procedures for treatment of Ankle Osteoarthritis are:
Arthroscopic Debridement to Treat Ankle Osteoarthritis:
This procedure is done in those cases where small fragments of bones or cartilage break away from their main part and float around causing irritation and pain in the ankle. These are called as loose bodies and sometimes some of these bones may get fixed between two bones causing significant pain and inflammation. To take care of this situation, a procedure called as arthroscopic debridement is done. In this procedure an instrument called as arthroscope which is an instrument with a minute camera is inserted in the ankle by making a small nick in the ankle to remove these loose bodies and relieve the pain and inflammation. This procedure also goes a long way in improving range of motion of the ankle.
Ankle Fusion to Treat Ankle Osteoarthritis:
This is quite a complex procedure and is recommended for those patients who have little to no motion of the ankle. This procedure is also known by the name of arthrodesis. Postsurgery, the patient is almost pain free and is able to ambulate normally but due to the fusion of the ankle joints it may not be possible for him to run or jog. Postsurgery, the patient will be given new set of shoes as there is limited movement of the ankle due to the fusion. The rocker sole can be of great help in this case. This surgery is not recommended for athletes who do a lot of running but for young active individuals this procedure is quite effective in getting rid of pain and inflammation caused due to Ankle Osteoarthritis and can be a permanent solution, although on the hindsight the success rate of this procedure is not that encouraging.
Ankle Replacement Surgery:
Ankle replacement is suggested for people who cannot have the above two procedures. This is also quite a complex procedure as the natural and degenerated parts of the ankle are removed and artificial parts are put in for pain relief and for a stable ankle even though an ankle replacement is not that much successful as the other forms of replacements like the knee or the hip. There is viable reason behind this. The ankle mortise is made up of two bones the tibia and the fibula and they facilitate smooth motion of the ankle with ambulation. In case of an artificial ankle, it at times becomes difficult to connect the mortise to the implant which may lead to failure of the implant and ultimate failure of surgery. Other than that the implant may also become loose with time and use and may cause further severe pain in the ankle. With further advancement of technology surgeons came up with a new technique in which they try and join the two bones tibia and fibula to the bones with the help of screws. After doing this, the success rate for ankle replacements have increased tremendously and this technique is widely used these days for ankle replacement for patients with Ankle Osteoarthritis, although normally it is done for people with posttraumatic Ankle Osteoarthritis.
What is the Recovery Period for Ankle Osteoarthritis Postsurgery?
Postsurgery, the ankle will be heavily bandaged and dressed for wound healing. A splint may also be placed for protection and immobilization. Depending on the extent of the surgery to treat ankle osteoarthritis, the patient will be recommended to not put any weight on the affected foot for a period of a few weeks to a couple of months. Once the wound has healed completely and the patient is able to move the ankle a bit, then the patient will be sent to physical therapy.
The physical therapy may be done two to three times a week for four to six weeks. During physical therapy, the patient will be worked on strengthening the ankle and improve range of motion. Gait training will also be provided once the ankle is stable and strong enough to bear the patient’s weight. Then the patient will be asked to weight bear gradually on the affected ankle with pain as the guide and over a span of a few months the patient may be made full weightbearing to the ankle. Complete recovery following surgical treatment for ankle osteoarthritis can range anywhere from 3-6 months.
In summary, Ankle Osteoarthritis is not a challenging condition which takes a lot out of an individual. In mild stages, it can be controlled with medications alone but in advanced stages surgery may be required to treat this condition. Hence it is always recommended to lead a healthy lifestyle, exercise regularly, walk daily, and take plenty of calcium to keep the bones healthy to stay away from conditions like Ankle Osteoarthritis.