Ankle Arthritis

Ankle arthritis is the gradual wearing away of the smooth cartilage that cushions the joint where the leg meets the foot. As the cartilage thins, the space between the bones narrows, bone spurs form at the edges, and the joint becomes painful, stiff, and swollen. Unlike hip or knee arthritis, ankle arthritis usually follows an earlier injury, such as a fracture into the joint, repeated sprains that left the joint loose, or direct cartilage damage. The original injury can be years in the past. Ankle arthritis cannot be cured, but it can be managed well, and most people relieve their pain and stay active for a long time.

Common symptoms include:

• A deep ache at the front or sides of the ankle, worse after activity and, later, at rest
• Stiffness that is worst in the morning or after sitting
• Swelling around the ankle that comes and goes
• A shorter stride and trouble on uneven ground, curbs, and gravel
• A grinding or catching sensation once bone spurs form

Ankle arthritis is diagnosed from your symptoms, a physical examination of motion, alignment, and stability, and standing X-rays that show how much joint space remains and where bone spurs have formed. A CT scan maps the bone in detail when surgery is planned, and an MRI adds soft-tissue information when needed.

Most people are treated without surgery:

• Activity changes toward lower-impact options such as cycling or swimming
• A stiff-soled rocker-bottom shoe or a rigid ankle brace to ease walking
• Physical therapy to strengthen the muscles around the ankle
• Anti-inflammatory medication for pain and swelling
• A steroid injection in some cases to calm a flare

Surgery is considered when bracing, therapy, and injections no longer keep you comfortable. Ankle fusion permanently joins the bones to remove the pain, while total ankle replacement preserves motion in a more selective group of patients.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Arthritis of the Foot and Ankle — AAOS OrthoInfo