Mr. K P  Meda, Foot & Ankle Surgeon
 
Multimedia Patient Education
Appointments
Facebook, LinkedIn, Twitter
 

Ankle

What is Ankle Arthritis?

Arthritis is a condition which affects joints in the body. The surface of the joint is damaged and the surrounding bone grows thicker.

To understand how arthritis develops, you need to know how a normal joint works. A joint is where two bones meet. The ends of the bones are covered by a thin layer of gristle called cartilage. This cartilage cushions the joint and spreads the forces evenly when you put pressure on the joint. The smooth, slippery cartilage surface also allows the bone ends to move freely. When a joint develops arthritis, the cartilage gradually roughens and becomes thin, and the bone underneath thickens or erodes.

What causes Ankle arthritis?

There are three types of arthritis that may affect your ankle.

Osteoarthritis

Osteoarthritis, also known as degenerative or "wear and tear" arthritis, is a common problem for many people after they reach middle age. Over the years, the smooth, gliding surface covering the ends of bones (cartilage) becomes worn and frayed. This results in inflammation, swelling, and pain in the joint. Osteoarthritis progresses slowly and the pain and stiffness it causes worsens over time.

Rheumatoid Arthritis

Unlike osteoarthritis which follows a predictable pattern in certain joints, rheumatoid arthritis is a system-wide disease. It is an inflammatory disease where the patient's own immune system attacks and destroys cartilage.

Post-Traumatic Arthritis

Post-traumatic arthritis can develop after an injury to the foot or ankle. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, severe sprain, or ligament injury.

What are the symptoms and signs of osteoarthritis?

Signs and symptoms of arthritis of the ankle vary, depending on the stage of the arthritis. Common symptoms include:

  • Pain or tenderness
  •  Stiffness or reduced motion
  •  Swelling
  •  Difficulty walking due to any of the above

Achilles Tendon  Disorders

Achilles tendonitis is an inflammation of the Achilles tendon. This inflammation is typically short-lived. Over time the condition usually progresses to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears. Sometimes the degeneration involves the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

As “overuse” disorders, Achilles tendonitis and tendonosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain. 

Treatment approaches for Achilles tendonitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon.  If non-surgical approaches fail to restore the tendon to its normal condition, surgery may be necessary. The foot and ankle surgeon will select the best procedure to repair the tendon.   


Ankle Fractures and Broken Ankles

A fracture is a partial or complete break in a bone. In the ankle, fractures can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both. Following an ankle injury it is important to have the ankle evaluated by a foot and ankle surgeon for proper diagnosis and treatment. If you are unable to do so right away, go to the emergency room and then follow up with a foot and ankle surgeon as soon as possible for a more thorough assessment.


Ankle Pain

Ankle pain is often due to an ankle sprain but can also be caused by ankle instability, arthritis, gout, tendonitis, fracture, nerve compression (tarsal tunnel syndrome), infection and poor structural alignment of the leg or foot. Ankle pain can be associated with swelling, stiffness, redness, and warmth in the involved area. The pain is often described as an intense dull ache that occurs upon weight bearing and ankle motion.  Initial treatment may consist of rest, ice, elevation, and immobilization, but may also include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, physical therapy, and cortisone injection. A foot and ankle surgeon can best determine the cause of the ankle pain and appropriate treatment options.


Ankle Sprain

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue—like rubber bands—that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.

When you have an ankle sprain, rehabilitation is crucial—and it starts the moment your treatment begins. Your foot and ankle surgeon may recommend physiotherapy.
In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligament or ligaments. The foot and ankle surgeon will select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level.

After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome. Be sure to continue to see your foot and ankle surgeon during this period to ensure that your ankle heals properly and function is restored.


Peroneal Tendon Injuries

In the foot, there are two peroneal tendons. They run side-by-side behind the outer ankle bone. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains.

Peroneal tendon injuries may be acute (occurring suddenly) or chronic (developing over a period of time). They most commonly occur in individuals who participate in sports that involve repetitive ankle motion. In addition, people with higher arches are at risk for developing peroneal tendon injuries.


Chronic Ankle Instability

Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing. Many athletes, as well as others, suffer from chronic ankle instability.

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not rehabilitated completely. Repeated ankle sprains often cause—and perpetuate—chronic ankle instability. Having an ankle that gives way increases your chances of spraining your ankle repeatedly. Each subsequent sprain leads to further weakening (or stretching) of the ligaments—resulting in greater instability and the likelihood of developing additional problems in the ankle.

In some cases, the foot and ankle surgeon will recommend surgery based on the degree of instability or lack of response to non-surgical approaches. Surgical options mainly involve repair or reconstruction of the damaged ligament(s). However, other soft tissue or bone procedures may be necessary depending on the severity of your condition and whether you have other problems in the foot or ankle. The length of the recovery period will vary, depending on the procedure or procedures performed.


Arthroscopic Surgery

Arthroscopy is a minimally invasive procedure that allows surgeons to diagnose and treat joint injuries through small incisions in the skin. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as X-rays, MRI, CT scans. During an arthroscopic procedure, a thin fiberoptic light, are inserted into the problem area, allowing the doctor to examine the joint in great detail.
For some patients it is then possible to treat the problem using this key hole surgery. Sports injuries are often repairable with arthroscopy. Cartilage damage is repaired through the arthroscope. 

Because it is minimally invasive, arthroscopy offers many benefits to the patient over traditional surgery. There is no cutting of muscles or tendons. The smaller incisions lead to minimal scarring. This lead to faster recovery and return to regular activities
Arthroscopy is not appropriate for every patient. Your doctor will discuss the diagnostic and treatment options that are best for you.


Total Ankle Replacement

Symptoms

The symptoms of a degenerative ankle joint usually begin as pain while bearing weight on the affected ankle. You may limp and the ankle may become swollen with fluid. The degeneration can lead to a reduction in the range of motion of the affected ankle. Bone spurs will usually develop and can be seen on X-ray. Finally, as the condition becomes worse, the pain may be present all the time and may even keep you awake at night.

Diagnosis

The diagnosis of a degenerative ankle starts with a complete history and physical examination by your doctor. X-rays will be required to determine the extent of the degenerative process and may suggest a cause for the degeneration.

Ankle Replacement Surgery

In ankle replacement surgery, the damaged bone and cartilage are replaced with metal and plastic surfaces that are shaped to restore ankle movement and function. The new artificial ankle is called a prosthesis. The prosthesis is generally composed of two metal pieces fitted onto the ends of the tibia (shin bone) and the talus (heel bone) and a plastic piece inserted between them to act as a bearing.

 

  © Mr. K P Meda Foot & Ankle Surgeon Birmingham UK   Your Practice Online
  Foot Ankle Sports Injuries Joint Replacement
 
 
 
 
Extra Corporeal Sound Wave Treatment [ESWT] Twitter LinkedIn Facebook