Arthritis of the ankle

Does your ankle hurt when you walk or do physical activity?

If so, that could be a sign of arthritis of the ankle. Unlike many other forms of arthritis, arthritis of the ankle is not a symptom of age, but often the result of a sports injury. Arthritis of the ankle thus often affects younger patients. It is one of the most common complaints of the motor system.

Symptoms of arthritis of the ankle 

In the early stages, pain and swelling only occur occasionally and after stress has been applied. The pain can occur at night or when standing still when the condition is more advanced. There is in addition a restriction to the movement radius up to complete stiffening. There may also be cracking sounds during movement.

Typical symptoms are:

• Pain when starting to move
• Pain when stress or weight is applied
• Incorrect weight application
• Swelling
• Cracking sounds
• Pain when resting and at night (in advanced stages)
• Stiffness
• Loss of strength
• Incorrect positioning of the ankle

If you have problems in this area, it is important that you seek a doctor as quickly as possible to slow the advancing wear and tear on the joint.

Diagnosis of arthritis of the ankle 

The mobility of the ankle is investigated in the clinical examination. An analysis of the gait is carried out if there is suspected arthritis.

An x-ray examination will yield information about any bone changes in the joint. Typical features are narrowing of the joint space, cysts and increased bone formation under the joint cartilage.

Treatment of arthritis of the ankle 

Arthritis of the ankle and consequent damage to cartilage and bones cannot be reversed. However, pain can be reduced, and the progression of the condition can be slowed by taking appropriate measures.

Conservative treatments for ankle arthrodesis 

• Painkillers
• Physiotherapy
• Bandages
• Provision of orthopaedic shoes

Surgical treatments for ankle arthrodesis 

If conservative treatments do not lead to the desired outcome, surgical treatment should be considered. The following procedures are available:

Arthroscopy of the ankle 

Arthroscopy of the ankle is a minimal invasive operation (keyhole-surgery), in which only small incisions are needed. A camera and the instruments are inserted through these 1 to 1.5 cm long openings in the skin. Joint mucus membranes and bone fragments are removed. The intervention usually takes place under regional anaesthetic.

Arthrodesis 

In a stiffening of the ankle, called arthrodesis, the joint cartilage is completely removed. The tibia is then connected to the upper ankle with screws or plates. Because of this, the bones fuse together again.  Patients do not feel any pain after the operation. However, there is less movement. Full weight can be applied to the joint again and walking is possible without difficulty. Many patients can also undertake physical activities like walking, running, cycling or skiing without any problems.

Artificial joint replacement 

In joint replacement (total anke replacement),  the damaged joint is replaced by an implant. This maintains the mobility of the joint, thereby protecting the adjacent joints and tissues. However, the indication of an ankle replacement must be very carefully made as this implant is only suitable for selected patient groups.

Dr. Klotz has many years of experience in treating arthritis of the ankle and is one of the most experienced specialists in the field of correction of incorrect foot positions. This treatment procedure is unavoidable in the most challenging circumstances.

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