Foot & Ankle
Ankle Arthritis
What is ankle arthritis?
Ankle arthritis is a painful condition that affects the ankle joint. In a healthy ankle, rubbery material called cartilage covers the bones and helps them to slide smoothly against each other. Ankle arthritis occurs when this layer of cartilage is damaged or breaks down and the bones in the ankle grind together.
What Causes Ankle Arthritis?
The most common cause of ankle arthritis is ‘wear and tear’ damage to the joint cartilage. This often occurs with age. A sudden or traumatic injury such as a broken bone or torn ligament can also cause the ankle joint to become arthritic. In some instances, an inflammatory, auto-immune disease (rheumatoid arthritis) can attack the lining of the body’s joints and cause ankle arthritis as a result.
A number of factors are known to contribute to ankle arthritis. These include:
- Being overweight
- Getting older
- Having a joint injury
- Undertaking activities which place extra stress on the ankle
Ankle Arthritis Symptoms
Symptoms of ankle arthritis include:
- A limited range of motion
- A sensation of grinding within the joint
- Difficulty walking, running or standing
- Stiffness in the ankle
- A sharp stabbing pain or dull ache
- Swelling
Diagnosing Ankle Arthritis
Your GP or Dr Shaun de Villiers can diagnose ankle arthritis. This is usually done through a blood test, x-ray, and sometimes an MRI scan.
Ankle Arthritis treatment
Non-surgical treatments are usually recommended for early stage ankle arthritis. These include; weight loss, activity modification, physiotherapy, anti-inflammatory medication, cortisone injections and joint supplements.
Surgery for Ankle Arthritis
If conservative treatments do not relieve your pain, Dr Shaun de Villiers may recommend surgery. Most surgeries for ankle arthritis aim to:
- Restore your quality of life
- Relieve pain
The most common types of surgery for ankle arthritis include:
- Ankle Arthroscopy – typically performed in the early stages to remove scar tissue, damaged ligaments, or bony spurs that may be causing pain or restricting movement.
- Ankle Fusion Surgery (Arthrodesis) – a procedure to permanently join the bones of the ankle joint (the tibia, fibula, and talus) to eliminate movement and relieve pain, usually caused by severe arthritis or deformity.
Ankle Reconstruction
What is Ankle reconstruction?
Ankle reconstruction surgery involves reconstructing the ankle ligaments. This is usually achieved through retightening the lax ligaments and occasionally does need a tissue graft obtained from other ligaments and/or tendons from the foot or ankle or artificial ligaments.
Why do I need an ankle reconstruction?
Dr Shaun de Villiers will usually recommend an ankle reconstruction if all other non-surgical approaches have failed. Specifically, surgery may be required if your ankle has not responded to the following treatments tried for a prolonged period of time:
- Physiotherapy
- Immobilization with brace
What happens during an ankle reconstruction?
What happens during an ankle reconstruction?
- Arthroscopy (Key hole surgery)
- Ankle Ligament Reconstruction (Open surgery)
The ankle reconstruction, is usually done via open surgery. Reconstruction involves retightening the torn ligament with stitches, or in some cases, actually rebuilding the damaged ligament by replacing it with a graft from other ligaments within the foot or ankle.
What happens after surgery?
After surgery you will need to keep your ankle immobilized. This is usually done through the use of a plaster cast or protective boot. It is important that you keep ankle immobilized for the time recommended by your surgeon as removing them too soon, you risk re-tearing the ligaments.
Rehabilitation from ankle reconstruction surgery involves time. The length of your recovery will depend upon the extent of your injury and the amount of surgery that you needed. Rehabilitation time can range from a few weeks to a few months.
You will also need to undertake physiotherapy exercises to help you restore strength to your ankle. Dr de Villiers will talk to you about this.
Joint Fusion Procedure
What is Joint Fusion Procedure?
Ankle Joint Fusion Procedure, also known as ankle arthrodesis, is a surgical procedure which aims to relieve pain and maintain or improve ankle function. It is most commonly used for patients with advanced ankle arthritis. During a Joint Fusion Procedure, the ankle bones are fused together. This eliminates movement in the joint and reduces arthritic pain.
Is a Joint Fusion procedure right for me?
Dr Shaun de Villiers will usually recommend a joint fusion if all other non-surgical approaches have failed. Surgery may be required if your ankle has not responded to treatments tried for a prolonged period of time.
What happens during a joint fusion procedure?
Ankle fusion surgery, or arthrodesis, is a procedure to permanently join the bones of the ankle joint (the tibia, fibula, and talus) to eliminate movement and relieve pain, usually caused by severe arthritis or deformity. Dr Shaun de Villiers will remove damaged cartilage and fix the bones together using screws, plates, or rods, allowing them to fuse over time. This procedure stabilizes the joint, reduces pain, and improves function, though it limits ankle mobility.
Recovery from a joint fusion procedure
Your recovery time will depend on a number of variables, and our surgeon will talk to you about what to expect when you attend your consultation in our rooms.
Typically, Dr Shaun de Villiers will recommend not bearing weight on your ankle for at least six to eight weeks. Most patients find this time difficult, and typically rely on crutches, walkers, wheelchairs or knee scooters to move around.
Make sure that you prepare your home prior to surgery. This may involve adding ramps instead of stairs, or moving your bed to the ground level. You might also need aids such as commodes, railings or shower chairs. It’s also a good idea to have someone at home with you to help you with basic tasks like cooking or getting to the shops.
Any non-absorbable stitches are usually removed 10 to 14 days after surgery. After six to eight weeks your ankle will probably be strong enough to use a walking boot. After about 12-16 weeks, you’ll likely be ready to walk without a boot and begin transitioning back to more vigorous activities.