Ankle Arthritis

Ankle Arthritis
Xray showing the results of severe ankle arthritis

The pain and reduced mobility caused by ankle arthritis can prevent you from doing the things you enjoy.

Primary ankle arthritis is rare,the commonest cause is post traumatic. Other causes include inflammatory arthropathies such as rheumatoid arthritis and psoriasis and also haemophilia. Patients usually present with pain and stiffness and sometimes instability.

Treatment for ankle arthritis initially consists of anti-inflammatories, modification of activity and orthotics. Should these fail there are a number of surgical options including initially a debridement of the ankle. The definitive treatments are either an arthrodesis(fusion) or an arthroplasty(joint replacement).

 

Figure shows arthroscopic debridement of osteochondral injury.

Anthroscopic Ankle Fusion is a less invasive way of performing a fusion and some surgeons believe this leads to a quicker recovery. The operation is performed through small incisions using

arthroscopic instruments rather than the more conventional open fusion requiring larger incisions.

Ankle arthroscopy is a technique where a camera is placed inside the ankle joint. This allows direct visualisation of the joint to assess any pathology. It is also possible to treat some conditions arthroscopically such as osteochondral injuries (where the cartilage in the joint is damaged) and impingement by resecting bony spurs.

Other options include lateral ligament reconstruction in cases of lateral instability and early medial compartment arthritis. Joint distraction with an Llizarov construct and corrective osteotomies have also been described.

When conservative treatments fail Total Ankle Replacement surgery can reduce pain significantly and help you return to an active life.

Rebalance Total Ankle Replacement(Biomet) implant

We currently use the Rebalance Total Ankle Replacement. The Rebalance Total Ankle Replacement is one of the newest replacements to be launched. It was first released in May 2011 in a limited fashion. The implant has a surface coating of Bonemaster which has been very successfully used in total hip replacements. The polyethylene insert is made of ʻEʼ poly (Vit E infused polyethylene) which has been shown to have 85% lower wear rates in vitro compared to existing replacements. Over 200 ankles have now been implanted. The early results are encouraging with a very low incidence of radiolucent lines and no early balloon osteolysis.