Ankle arthritis
What causes it?
Unlike the hip and knee, which are prone to develop primary osteoarthritis, the ankle develops arthritis usually because of a traumatic event. In 70% patients with ankle arthritis there is a history of trauma (ankle fracture or a significant ankle sprain). The second most common cause of ankle arthritis is Rheumatoid arthritis.
How to diagnose it?
The most common location of pain is anterior which gets worse by walking uphill. Pain caused by going downhill suggests problem at the back of ankle usually due to posterior impingement. Pain caused by walking on uneven grounds is indicative of subtalar joint problems. In late stages of ankle arthritis, the movements (dorsiflexion & plantar flexion) are restricted. …show more content…
Correction of varus or valgus deformities can improve pain and function and delay ankle fusion or replacement.
6) Ankle fusion: Most of the ankle fusions can be now performed by keyhole surgery, which avoids the morbidity and complications of the open surgery. (Fig 10.8)
7) Ankle Replacement: Ankle replacement has gained popularity in the last 15 years. The advantages of this surgery include: preserved movements, less stress on other joints and improved gait. The current third generation implants have resulted in improved outcome. The survivorship of one make of ankle replacements (Hintegra) has been reported to be 84% at 10 years for a group of 684 patients (Ref 3). The ideal candidate for ankle replacement surgery is a low demand patient with preserved movements and deformity less than 10 degrees. (Fig 10.9)
Take home message: Ankle arthritis is usually post traumatic. Ankle fusion is the gold standard treatment for end stage arthritis. Though ankle replacement is not as successful as hip and knee replacement, the results are improving and can lead to a good outcome in carefully selected patients.
Bunion (Hallux
What causes it?
Unlike the hip and knee, which are prone to develop primary osteoarthritis, the ankle develops arthritis usually because of a traumatic event. In 70% patients with ankle arthritis there is a history of trauma (ankle fracture or a significant ankle sprain). The second most common cause of ankle arthritis is Rheumatoid arthritis.
How to diagnose it?
The most common location of pain is anterior which gets worse by walking uphill. Pain caused by going downhill suggests problem at the back of ankle usually due to posterior impingement. Pain caused by walking on uneven grounds is indicative of subtalar joint problems. In late stages of ankle arthritis, the movements (dorsiflexion & plantar flexion) are restricted. …show more content…
Correction of varus or valgus deformities can improve pain and function and delay ankle fusion or replacement.
6) Ankle fusion: Most of the ankle fusions can be now performed by keyhole surgery, which avoids the morbidity and complications of the open surgery. (Fig 10.8)
7) Ankle Replacement: Ankle replacement has gained popularity in the last 15 years. The advantages of this surgery include: preserved movements, less stress on other joints and improved gait. The current third generation implants have resulted in improved outcome. The survivorship of one make of ankle replacements (Hintegra) has been reported to be 84% at 10 years for a group of 684 patients (Ref 3). The ideal candidate for ankle replacement surgery is a low demand patient with preserved movements and deformity less than 10 degrees. (Fig 10.9)
Take home message: Ankle arthritis is usually post traumatic. Ankle fusion is the gold standard treatment for end stage arthritis. Though ankle replacement is not as successful as hip and knee replacement, the results are improving and can lead to a good outcome in carefully selected patients.
Bunion (Hallux