Could your foot or ankle pain be arthritis?

Are you troubled by:

• Pain or swelling in your feet or ankles?
• Difficulty walking?
• Foot or ankle stiffness or reduced motion?

You could have arthritis in your feet or ankles.

“Ankle arthritis is much less common than hip, knee or shoulder arthritis,” says Daniel Zanotti, MD. “We see a lot of foot and ankle arthritis simply because we treat a lot of trauma patients such as ankle fractures. Even the best fracture treatment can still lead to arthritic changes down the road.”

Dr. Daniel Zanotti answers questions about ankle arthritis

What causes arthritis of the ankle?

• Trauma. “By far, the most common cause of ankle arthritis is trauma—previous ankle fractures to the tibia, fibula or talus bone.”
• Osteochondritis dissecans. “This is a condition where the cartilage stops adhering to the bone and flakes away, leading to arthritis. Osteochondritis dissecans can affect people of any age, but we sometimes see it in patients as young as 10 or 12. It can be caused by trauma, where the cartilage is chipped away, but it can also be something we think is genetic or from an unknown cause.”
• Lax ankle ligaments. “People who have laxity of the ankle ligaments or chronic ankle sprains are more prone to develop arthritis because the bones slide in ways they weren't meant to slide. Over time, that can lead to wearing down or arthritis.”

How is foot and ankle arthritis treated?

The first line of treatment for arthritis of the foot and ankle consists of conservative, non-surgical methods such as:

• NSAIDs—either prescription or over-the-counter
• Physical therapy to stabilize the ankle
• Bracing
• Shoe inserts called orthotics
• Cortisone injections to treat inflammation
• Hyaluronic acid injections to lubricate the affected joint

How is osteochondritis dissecans treated?

“If conservative treatments fail, osteochondritis dissecans can sometimes be treated with a cartilage transplant.

Where do you obtain the cartilage for a transplant?

“There are two possible sources for cartilage:

• An autologous transplant uses your own cartilage borrowed from the knee or another part of the ankle.
• An allograft transplant uses cartilage from a donor.”

Do you ever recommend surgery for early-stage ankle arthritis?

“In some cases, yes. One surgical option that can't necessarily fix arthritis, but can help if there are loose pieces in the ankle or in early-stage arthritis is an arthroscopy.”

What are the surgical options for late-stage ankle arthritis?

“In later stages of ankle arthritis, there are two options:

• Ankle fusion, where we glue the bones together so they don't move. That obviously relieves the pain, because there's no sliding between the bones, but it does limit the motion in the ankle joint and it causes stiffness.
• Ankle replacement, which is an appropriate option for older, less-active adults. This procedure can maintain the ankle's flexibility and range of motion while providing pain relief.”

Why don't you recommend ankle replacement for younger, more-active patients?

“If a patient is younger or more active, he or she will wear down an ankle replacement much too quickly and another surgery would be needed. An ankle fusion or arthrodesis, is a permanent solution.

“Ankle replacements haven't been around very long in the U.S., so the technology is improving. They will get better and better.”

Could you have foot or ankle arthritis?

Request a consultation

This information is simply an introduction to foot and ankle arthritis. To diagnose and treat your foot or ankle condition, we invite you to schedule a consultation with one of our board-certified orthopedic surgeons.

Call 440.329.2800 for an appointment