Ankle Arthritis

Ankle Arthritis Overview

Ankle arthritis refers to degeneration of the cartilage within the ankle joint, leading to pain, stiffness, and reduced mobility. Unlike hip and knee arthritis, which often develop due to age-related wear and tear, ankle arthritis is more commonly the result of previous trauma — such as a fracture or repeated sprains.

The condition can significantly affect mobility, particularly on uneven ground, stairs, or during long periods of standing or walking.

Ankle Arthritis Symptoms and Diagnosis

Common symptoms include:

• Pain and stiffness in the ankle, especially in the morning or after rest

• Swelling around the joint

• A grinding or catching sensation during movement

• Difficulty walking or standing for long periods

• Pain that worsens with activity and improves with rest

• In more advanced cases, the ankle may become visibly swollen, deformed, or unstable

Diagnosis is made by clinical assessment and confirmed with imaging:

• X-rays show narrowing of the joint space, osteophyte formation, or bone-on-bone contact

• MRI or CT scans may be used for detailed assessment of cartilage, bone quality, and joint alignment

Ankle Arthritis Causes

Ankle arthritis is most commonly due to post-traumatic arthritis following:

• Ankle fractures or dislocations

• Repeated ankle sprains

• Chronic ankle instability

Other causes include:

• Osteoarthritis (age-related cartilage degeneration)

• Inflammatory arthritis, such as rheumatoid arthritis

• Infection, gout, or avascular necrosis

Ankle Arthritis Treatment and Prevention

Many patients manage well with non-surgical treatment, especially in the early or moderate stages.

Conservative options include:

• Activity modification to avoid impact or long-distance walking

• Pain relief with anti-inflammatory medications (NSAIDs)

• Ankle bracing or lace-up supports to reduce stress on the joint

• Custom orthotics or rocker-soled shoes to improve gait and offload the ankle

• Physiotherapy to maintain joint movement, strength, and balance

• Corticosteroid injections to reduce inflammation and pain in flares

In selected cases, viscosupplementation (lubricant injections) may be considered, though less common in the ankle than other joints.

Ankle Arthritis Surgery

Surgery may be considered when conservative management fails and quality of life is significantly affected. The aim of surgery is to reduce pain, improve function, and preserve mobility where possible.

Options include:

• Arthroscopic debridement: Removal of loose cartilage, inflamed tissue, and bony spurs. Most effective in early stages.

• Osteotomy: Bone realignment surgery to shift pressure away from the damaged part of the joint (for specific deformities).

• Ankle fusion (arthrodesis): The damaged joint surfaces are removed and the bones fixed together, eliminating movement but relieving pain.

• Total ankle replacement (arthroplasty): The ankle joint is replaced with an artificial implant to preserve motion, used in selected patients with good bone quality and alignment.

Mr Hester will discuss the most suitable surgical approach with you, based on the severity of your arthritis, activity level, foot alignment, and overall health.

Ankle Arthritis Surgery Recovery

Recovery depends on the specific procedure performed:

• After arthroscopy, patients often weight-bear early and return to activity within weeks

• Following fusion or replacement, you will typically spend 6–8 weeks in a boot, initially non-weight-bearing or partially weight-bearing

• Wound review is usually at 2 weeks, followed by gradual physiotherapy

• Bone healing from fusion may take 3 months or longer

• After ankle replacement, physiotherapy focuses on restoring strength and range of motion while protecting the implant

Driving, work, and sport-specific activity will depend on your recovery and individual circumstances.