Ankle arthritis occurs when one wears out the joint between the shin bone (tibia) and ankle bone (talus), also called the tibiotalar joint. The ankle joint is affected by arthritis much less often than other joints.

What causes ankle arthritis?

Common causes of ankle arthritis include:

• Rheumatoid arthritis: An inflammatory disease affecting the lining of joints and destroys bones, joints and tissues.The condition often starts in smaller joints, like those found in the foot or ankle.
  
  The exact cause of rheumatoid arthritis is not known. Although it is not an inherited disease, researchers believe that some people have genes that make them more susceptible.
  
  When the body is exposed to a trigger, such as infection or another environmental factor, the immune system begins to attack the joint.
• Previous injury: In patients who sustain an ankle injury, such as a fracture, the cartilage may be damaged and lead to arthritis.
• Infection: Infections of a joint can damage cartilage cells. Because cartilage cells cannot regrow, the damage from an infection can be permanent.
• Genetics: Some people have a genetic tendency to wear out joints faster than others.
• Obesity: Patients who are overweight place a larger burden on their body's joints. These patients have more of a tendency to develop arthritis, and often have more accelerated damage to the joint cartilage.

What does it feel like?

Symptoms of ankle arthritis include:

• Pain
• Tenderness
• Swelling around the joint
• Stiffness of the ankle
• Deformity of the joint
• Instability
• Bone spurs, forming lumps around the joint

How do I know if I have ankle arthritis?

A physical examination of the foot, with focus on pain, will help your doctor with diagnosis.

A review of your medical history will also help your doctor understand if your symptoms are a result of a past foot injury, or if arthritis runs in your family.

X-ray imaging can show changes in the spacing between bones or in the shape of the bones, and also rule out other underlying conditions like fracture. Other imaging tools, such as magnetic resonance imaging (MRI), may also assist in diagnosis.

How is ankle arthritis treated?

Symptoms of arthritis may be relieved with improved (wider and less restrictive) footwear and orthodics, such as shoe inserts or arch supports, which may offer your feet padding and shielding. In some cases, custom-made shoes may be recommended.

Anti-inflammatory medicines -- such as aspirin or ibuprofen -- or cortisone injections may also be prescribed by your doctor.

Physical therapy, weight control, and nutritional supplements may also be recommended.

When nonsurgical treatments are no longer effective, surgery may be considered.

Surgeries include:

• Arthroscopy: Using tiny incisions, the surgeon can remove bone spurs, loose fragments, or a portion of the diseased bone lining.
• Arthrodesis (fusion): The surgeon fuses the bones of the joint completely, making one continuous bone.
• Arthroplasty (joint replacement): The damaged ankle joint is replaced with an artificial implant.

Treatment Videos

At Duke Orthopaedics, our doctors often treat severe ankle arthritis with ankle replacement surgery. The following video demonstrates ankle replacement surgery.