Osteoarthritis is a chronic, degenerative, joint disease. It’s the most common form of arthritis.
Here, we review the specific impact of osteoarthritis of the ankle, how this problem can develop, and what treatment options are currently available.
The symptoms of osteoarthritis in the ankle are similar to that in other forms of arthritis.
People with osteoarthritis in the ankle usually experience symptoms, such as:
- pain and stiffness that’s worse in the morning or after sitting for awhile
- tenderness when the joint is touched or squeezed
- swelling around the entire ankle or even just one side, especially with increased activity
- redness around the joint
- limited range of motion in ankle (difficulty bending or flexing it), having pain when doing so
- difficulty walking without pain and pain with putting weight on the ankle
Osteoarthritis of the ankle can also have repercussions on mental and emotional health, and your overall quality of life.
A study from 2021 found that people with late-stage ankle osteoarthritis ranked their quality of life poorly — on par with people who had advanced kidney and heart diseases.
Osteoarthritis is caused by a general wearing down of the cartilage between the bones in your joints.
For ankle osteoarthritis in particular, the most common cause overall is a previous ankle injury. In fact, 78 percent of all cases of ankle osteoarthritis result from an earlier ankle trauma. The remainder develop from unknown causes (idiopathic).
Even with proper treatment, an injured ankle joint is about 7 times more likely to develop arthritis than an uninjured one.
While the ankle is generally a stable joint made up of three bones, it has a very thin layer of cartilage. Your ankles support your entire body weight and every step you take, putting a lot of stress on these relatively small joints.
Changes in tension across the cartilage can easily cause injury and lead to early deterioration of the ankle joint. For these reasons, active younger people — especially athletes — are prone to developing osteoarthritis of the ankle.
A 2021 study revealed that the chances of developing osteoarthritis of the ankle range from 9 to 19 percent in former professional football players.
Medications, including injectables, to reduce pain and different forms of therapy are typically the first treatments attempted for osteoarthritis in the ankle. This can include over-the-counter options, such as non-steroidal anti-inflammatory drugs (NSAIDs), or prescription pain medications.
Eventually, in some cases, you may need a surgical procedure called arthrodesis, where bones are surgically fused together to support the joint.
Glucosamine is one of our body’s naturally-occurring amino sugars, and it helps keep cartilage and connective tissues strong and healthy. This supplement is taken orally. Although it’s commonly used for people with osteoarthritis, glucosamine sulfate is not approved by the Food and Drug Administration (FDA) for this purpose.
Viscosupplementation is an injectable medication that’s shown to reduce pain, and protect and restore cartilage damaged due to osteoarthritis. Repeat injections may be necessary for sufficient relief. Visco is not FDA-approved for the ankle, but some doctors still use it.
Bracing can also be very helpful in treating osteoarthritis in the ankle. Braces provide support to the joint, and limit the range of motion to avoid painful movements. This can help you use the joint more comfortably on a daily basis. One commonly recommended ankle brace is called the Arizona brace, which locks the ankle in position.
However, bracing long term can cause soreness and weakness. It’s important to talk with your doctor about which brace is right for you, and how to use it safety.
Surgical treatment options for osteoarthritis in the ankle include:
- repairing and reshaping the ankle joint
- removing or repairing damaged cartilage (chondroplasty)
- removing bone overgrowths (debridement or resection)
- using an external fixation device to realign the ankle join and provide stability (distraction arthroplasty)
- cutting the ankle bone to realign it (realignment osteotomy)
- repairing and possibly transplanting cartilage tissue (allograft)
- getting ankle fusion (ankle arthrodesis)
- undergoing artificial joint replacement (total ankle arthroplasty)
The decision about which procedure will work best for you depends on the severity of your osteoarthritis, how much movement you want to keep in your ankle, and your overall health.
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- previous joint injury or overuse
- joint misalignment
- age, especially those who are 40 and older
Having an improper gait (way of walking) or physical issue that affects your gait can also cause osteoarthritis. This can put irregular or too much pressure on your ankle joint.
Osteoarthritis is known to have a genetic link, so you may be more likely to develop this condition if you have family members with it. However, anyone can get osteoarthritis.
Women are also more likely to get osteoarthritis than men.
Your ankle joints support your entire body weight when you walk or perform other activities, so it can be particularly difficult to ignore when these joints are in pain.
If you’re very active, or play contact sports, you have a higher risk of developing osteoarthritis in your ankle later in life.
Osteoarthritis in the ankle can be treated with conservative, non-surgical treatments, including oral pain relievers and supplements, ankle braces, and injections in the joint. Surgical options vary widely, from repairing damage cartilage to fusing bones in the ankle.
If you’ve experienced a traumatic ankle injury, or have ankle pain due to an unknown cause, seek care. You need to rest and heal any existing injuries, and ask your doctor about your risk of developing osteoarthritis.