Ankle Arthritis

Joints such as the ankle have specialised articular (joint) cartilage and a small amount of lubricating joint fluid kept within the joint by a joint capsule. The capsule stops the fluid from leaking out. If the cartilage is damaged for any reason, this may lead to arthritis.

There is no cure for arthritis but there are many ways to help relieve symptoms. If managed effectively, people with arthritis may live healthy, active lifestyles with or without surgery.

Symptoms of Ankle Arthritis

The most common symptom of ankle arthritis is pain especially pain with activity and particularly first thing in the morning, along with progressive stiffness, swelling and clicking or catching of the ankle joint.

It can occur in any age group but is most common in the middle to older age groups and depends on the underlying cause.

Causes of Ankle Arthritis

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

  • Ankle fracture +/- dislocation
  • Articular cartilage damage
  • Chronic ankle instability
Other causes may be related to inflammatory arthropathy; most commonly rheumatoid arthritis, primary osteoarthritis which is relatively uncommon, and other causes such as septic arthritis (infected joint), Charcot arthropathy or haemochromatosis.

Imaging for Ankle Arthritis

  • Weight-bearing X-rays are required
  • Long leg X-rays, CT scans or MRI scans may be required
Non operative treatment for Ankle Arthritis

  • Topical pain creams e.g. NSAIDS
  • Pain medications e.g. NSAIDS such as Mobic or Panadol Osteo
  • Lace up ankle brace
  • Shoe wear modification
    • lace up ankle boots
    • stiffer-soled shoe with rocker bottom modification
  • Activity modification
    • improve fitness and strength via non axial loading exercises e.g. cycling, swimming.
    • avoid axial loading exercises e.g. running
  • Weight loss management
  • Joint injections
  • Occasionally viscosupplementation may help
Surgery for Ankle Arthritis

Surgery is considered if symptoms are progressing and function is decreasing after a trial of non-surgical treatment. Depending on the extent of disease, surgical options may include:

  • Arthroscopic procedures
    If bony impingement is contributing or causing symptoms and osteoarthrits is not widespread throughout the joint
  • Bone realignment osteotomy
    If osteoarthritis is focal then shifting the bone alignment may help decompress the painful area

  • Ankle fusion: open or arthroscopic
    If osteoarthritis is advanced and the patient suffers significant symptoms on a daily basis. More suited for younger, more active patients and those who work in manual labouring positions

  • Total ankle replacement
    Many factors are used to determine if a patient is suitable for joint replacement. This includes if osteoarthritis is advanced and the patient suffers significant symptoms on a daily basis. It is more suitable for older people who are not in manual labourer positions and whose activity can be restricted to lighter weight activities

  • Tibiotalocalcaneal Fusion (With Intramedullary Rod)
    This surgical procedure fuses your ankle joint with a rod commonly called a “nail.” It passes through the bones of your foot and lower leg. This type of fusion can be helpful if you have severe arthritis or other serious problems with your ankle. It may also be needed if you have had a total ankle replacement that has failed.

Ankle Fusion aka Ankle Arthodesis

Post-operative guide by Dr Danielle Wadley

Ankle Replacement

Post-operative guide by Dr Danielle Wadley

TibioTaloCalcaneal Fusion

Post-operative guide by Dr Danielle Wadley

Risks of ankle arthritis surgery

All surgery has risks involved, however every effort is made to reduce these risks. Risks include but are not limited to:

  • Infection: superficial wounds or deep infections
  • Clots: DVT (deep venous thrombosis) or PE (pulmonary embolus)
  • Nerve damage: tingling, numbness or burning
  • Ongoing pain
  • Stiffness of the ankle joint
  • General or anaesthetic risks including to the heart and lung
  • Drug reactions/allergy
  • Scarring or tethering of the skin
  • Rerupture
  • Calf weakness
  • Revision surgery

There are increased risks of surgery in diabetics, smokers, significant peripheral vascular disease, severe neuropathy, previous or current infection which may preclude a patient from surgery.

View FootForward for Diabetes (run by Diabetes Australia) for more information on foot care.  

For all appointments and enquiries, please phone 07 5645 6913 or email

9 Kinloch Avenue
Benowa QLD 4217


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