Ankle Cartilage Injury



Ankle Cartilage Injury

Cartilage is a connective tissue that cushions the bones and ensures the joint can move smoothly. Because of the number of bones in the ankle, the articular cartilage is easily damaged due to ankle sprains and other traumatic injuries. Symptoms include swelling, pain, stiffness, and inflammation, requiring medical intervention such as physical therapy or surgical repair.

Ankle Cartilage Injury

What Is An Ankle Cartilage Injury?

An ankle cartilage injury happens when the smooth tissue covering the ends of bones in a joint is damaged. Normally, the cartilage protects the bones against impact, absorbing the shock and allowing the bone surfaces to glide smoothly.

Unlike other tissues, cartilage does not have a blood supply. As such, if injured or damaged, cartilage takes a long time to heal and is susceptible to permanent damage. Articular cartilage, in particular, is vulnerable to injury, although it is springy, tough, and elastic.

Why Do Ankle Cartilage Injuries Occur?

Ankle cartilage injuries are primarily caused by stress and strain placed on the ankle joint. Due to its involvement in weight-bearing and mobility, the ankle joint is particularly vulnerable to strains and sprains. These can damage the cartilage injury over time.

Other potential causes include:

Sudden impacts or accidents, such as falling, twisting the ankle, or direct blows, can damage the cartilage.

Repetitive motion and excessive use, common in athletes or those with physically demanding jobs, can wear down cartilage over time.

Frequent ankle sprains or an inherently unstable ankle can lead to abnormal joint movement, wearing down the cartilage.

Conditions like osteoarthritis and rheumatoid arthritis cause the degradation of cartilage.

Misalignment of the ankle bones can cause uneven pressure on the cartilage, leading to quicker degeneration.

Ankle Cartilage Injury

Symptoms Of An Ankle Cartilage Injury

People with damaged joint cartilage in the ankle will experience:

Ankle Cartilage Injury

How Is An Ankle Cartilage Injury Diagnosed?

Diagnosing an ankle cartilage injury involves a combination of clinical evaluation and imaging studies. Your doctor will initially take a medical history and perform a thorough medical examination. Depending on if the injury is acute or chronic, the course of action may differ.

Patients are often asked about their history of ankle injuries, activity levels, and specific symptoms experienced.


​​X-rays cannot visualise cartilage directly because it's a form of soft tissue. However, it can help rule out other potential causes and injuries, including fractures and trauma. It can also help identify the underlying cause. For example, osteoarthritis is diagnosed via x-ray, allowing the visualisation of the joint space.

MRI Scan

Magnetic Resonance Imaging (MRI) is the most effective imaging technique for identifying cartilage injuries. It provides detailed images of hard and soft tissues, including cartilage, tendons, and ligaments around the ankle.

Your doctor can assess the condition of the cartilage, the severity of the damage, and any other abnormalities. It's especially helpful to identify bits of cartilage that have broken off.

CT Scan

Computed Tomography (CT) involves several different X-rays from multiple angles to provide a cross-sectional view of the joint. Used less frequently, it can also provide a good visualisation of the bone structures of the ankle and some soft tissues. CT is often preferred if an MRI proves inconclusive.


If the imaging results are not definitive, an arthroscopy may be performed. This minimally invasive procedure involves inserting a small camera into the ankle joint, allowing the doctor to visualise the cartilage and assess any damage directly.

Arthroscopy carries slightly more risk than other diagnostic tests, as the camera itself can damage the cartilage. However, the arthroscope can also remove pieces of cartilage if necessary.

Ankle Cartilage Injury

How Are Ankle Cartilage Injuries Treated?

Discover practical approaches to manage ankle cartilage injuries through various surgical and non-surgical treatments.

Non-surgical Treatments

Conservative treatment is the preferred option. It involves NSAIDs (non-steroidal anti-inflammatory drugs) to provide pain relief and reduce inflammation and physical therapy to strengthen the joint and prevent further damage. For most patients, this is sufficient to provide pain relief and improve mobility.

In some cases, a steroid injection is given if the inflammation is impinging the joint and preventing mobility.

Surgical Treatments

Surgery is necessary if the patient does not respond to conservative treatment. The surgeon will usually assess the individual's activity levels, age, and scale of the injury before agreeing to the procedure.

There are several surgical options:

Debridement and Lavage:
This involves the surgical removal of loose cartilage and debris from the joint, which can decrease irritation and pain.

Ankle Arthroscopy:
Using small incisions and miniature instruments, surgeons can smooth out rough surfaces, remove loose bodies, and perform other repairs to minimise pain and improve function.

Ankle Fusion:
This is considered when arthritis or injury has severely damaged the joint. The bones of the ankle are fused together, eliminating the joint to alleviate pain.

Total Ankle Replacement:
In severe cases, the damaged joint is replaced with an artificial implant, designed to replicate the movement of a normal ankle.

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