Arthritis of the Ankle



Arthritis of the Ankle

Ankle arthritis, though less prevalent, can significantly impair daily activities. Often caused by osteoarthritis, it leads to pain, stiffness, and swelling, hindering mobility. While pain relief and exercises offer initial relief, surgery may be needed for chronic cases. Prioritise managing ankle arthritis to regain mobility and enhance your quality of life.

Arthritis of the Ankle

What Is Ankle Arthritis?

Ankle arthritis is a degenerative joint condition where the cartilage that cushions the bones in the ankle wears down over time or becomes highly inflamed. The condition primarily affects the tibiotalar joint, which is where the shinbone meets the foot bone.

The term arthritis refers to joint inflammation. Inflammation is defined by four symptoms: redness, swelling, warmth, and loss of function. Unlike other causes, osteoarthritis, although it causes some inflammation, lacks the redness or swelling common in rheumatoid arthritis or a joint infection.

Types of Ankle Arthritis


Osteoarthritis (OA) is the most common form of arthritis affecting the ankle joint. It is a wear-and-tear condition that results from the gradual degradation of cartilage in the joint.  Because of its degenerative nature, osteoarthritis is linked to ageing. Gradually, over time, the protective cartilage is worn away, leading to bone rubbing on bone. This is extremely painful and restrictive. Surgical intervention is required to correct this condition.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune condition in which the body’s white blood cells attack the joint tissues, leading to severe inflammation and joint damage. RA primarily affects the small joints – including the joints of the hands and wrist. Large joint involvement is less common but can still occur. If left untreated, RA will continue to destroy the joint capsule, inevitably leading to a complete loss of joint function.

Posttraumatic Arthritis

Posttraumatic arthritis develops after an injury to the ankle, such as a fracture, severe sprain, or ligament damage that disrupts the normal alignment and functioning of the joint. As part of the injury, the blood supply to the ankle can be impaired, causing osteonecrosis (another risk factor for ankle arthritis). This type of arthritis is characterised by the wearing out of the cartilage due to joint instability and abnormal stress on the joint following injury.
Arthritis of the Ankle

Ankle Arthritis Symptoms

Ankle arthritis may present with any of the following symptoms:

Some individuals may experience fatigue, fever, and weight loss, indicating a more systemic, severe condition. If there are tingling or shooting pains, it means the inflamed tissue has impinged a nerve.

Arthritis of the Ankle

Ankle Arthritis Diagnosis

The diagnosis of arthritis of the ankle is primarily based on your history and a medical examination. If your doctor suspects a particular type of arthritis, you may undergo several tests to confirm the diagnosis and determine the severity of the joint damage.


X-ray is the most common initial test for diagnosing ankle arthritis – particularly osteoarthritis. The tests show the extent of the damage and deformity in the ankle joint. A narrow joint space, bone spurs, increased bone formation around the joint, and cyst formation are characteristic of osteoarthritis.

Previous damage to the joint due to trauma will also be apparent on the x-ray. However, rheumatoid arthritis will require another form of imagery.

MRI Scan

Magnetic Resonance Imagery (MRI) scans provide detailed images of the soft tissue of the ankle, including cartilage, ligaments, and tendons. This test is instrumental in differentiating between osteoarthritis and rheumatoid arthritis, as RA’s pattern of inflammation and damage will be easily visible.

CT Scan

Computed Tomography (CT) scans combine X-ray images taken from several different angles to create a cross-sectional view of the inside of the ankle. It can be used to diagnose all forms of ankle arthritis and provides a more detailed image of bone damage and anomalies.

Lab Tests

Neither osteoarthritis nor posttraumatic arthritis are easily diagnosed using lab tests. Rheumatoid arthritis, however, has several characteristic markers in the blood.

Arthritis of the Ankle

Ankle Arthritis Treatments

Discover practical approaches to relieve the symptoms of ankle arthritis through various surgical and non-surgical treatments.

Non-surgical Treatments

Conservative treatment of ankle arthritis involves pain relief, and shoe inserts. Pain relief and anti-inflammatory medications can help moderate symptoms. However, long-term use can lead to possible side effects.

Steroid injections are another possibility – especially during an acute flare-up of pain. But if given repeatedly, it can lead to further degradation of the joint.

Orthotics can help modify your shoes to increase your comfort. Cushioned inserts, for example, can reduce the pressure on the ankle, while braces can hold the ankle joint in position.

Surgical Treatments

As the condition progresses, surgical intervention becomes more common. Usually, surgeons will wait until the condition severely impacts your daily life. There are two primary options:

Ankle Fusion Surgery:
Standard treatment for advanced ankle arthritis, this surgery removes the worn-out joint parts and permanently fuses the bones together to alleviate pain and stabilise the joint.

Ankle Replacement Surgery:
A less common and more debated option for treating ankle arthritis, involving the replacement of the affected joint with an artificial implant. Though less experienced compared to fusion, ongoing improvements in implant design are expected to enhance outcomes.

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