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Oxford University Hospitals NHS Foundation Trust
Foot and Ankle

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Arthritis

Most ankle arthritis is caused by wear and tear, and this is known as osteoarthritis. (However, there are other forms of arthritis that affect the ankle, for example, rheumatoid arthritis.) Early symptoms of ankle arthritis are pain and perhaps swelling, especially after prolonged activity including standing or walking, or after high impact activities, for example running. If you have ankle arthritis, pain and swelling can become more frequent as the disease progresses. Eventually you will probably feel pain most of the time, even when you are not active.

Non-surgical treatments include non-steroidal anti-inflammatory tablets, reducing high-impact activities, maintaining an appropriate weight for your age and height - a good, lightweight, stiff walking boot may also be useful in relieving the symptoms of an arthritic ankle. 

Surgical options include ankle arthroscopy (keyhole surgery) in arthroscopic and debridement) which should help to minimise the pain, swelling and stiffness that you experience in your ankle. Through two small holes, the surgeon will insert instruments into your ankle to remove loose piece of bone, cartilage, inflamed tissue and bone spurs. After the operation you will need to rest your ankle for about 48 hours - you may find ice useful in helping to reduce the post-operative swelling. Results from ankle arthroscopy are usually very good.

However, and depending on the state of your arthritic ankle, your surgeon may decide that fusion is the best way forward. This operation involves cutting the arthritic joint on both sides back to healthy bone. The joint is then placed in a functional position and using screws, the ankle is held in place until it is fused.  Occasionally a large metal rod may be placed through the heel which will compress the ankle and sub-talar joints - this is known as a double fusion. 

If neither of the above surgical options is felt suitable for you, your surgeon may consider an ankle replacement. However, this type of surgery generally needs revision after ten years and is not suitable if you are employed in heavy manual work or want to start or continue with sporting activities.

Your surgeon will be happy to discuss your options with you fully.