Ankle Arthritis

What Is Arthritis?

Arthritis is inflammation resulting from the degeneration of cartilage in the joint causing pain, swelling, and stiffness in the joints resulting in restricted movements.

What Causes Arthritis of the Foot and Ankle?

Arthritis of the foot and ankle joint can occur due to fracture, dislocation, inflammatory disease, or congenital deformity.

What Foot and Ankle Joints Are Commonly Affected by Arthritis?

 The foot and ankle joints most commonly affected by arthritis are:
  • The joint between the shin bone (tibia) and ankle bone (talus)
  • The three joints of the foot that include the heel bone, the inner mid-foot bone, and the outer mid-foot bone
  • The joint of the great toe and foot bone

Types of Arthritis Affecting the Foot and Ankle

There are three types of arthritis affecting the foot and ankle which include:
  • Osteoarthritis: Also called degenerative joint disease, this is the most common type of Arthritis, which occurs most often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, called a bone spur. 
  • Rheumatoid Arthritis: This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, and loss of function in joints. Rheumatoid Arthritis affects mostly joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (both feet) at the same time and with the same symptoms. 
  • Post-traumatic Arthritis: Arthritis developing following an injury to ankle or foot is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain, or ligament tear.
Rheumatoid arthritis is often caused when the genes responsible for the disease is triggered by infection or any environmental factors. With this trigger, the body produces antibodies, the defence mechanism of the body, against the joint and may cause rheumatoid arthritis. Fractures at joint surfaces and joint dislocations may predispose an individual to develop post-traumatic arthritis. It is considered that your body secretes certain hormones following injury which may cause the death of the cartilage cells. Uric acid crystal build-up is the cause of gout and long-term crystal build-up in the joints may cause deformity. 

Symptoms of Foot and Ankle Arthritis

Symptoms of foot and ankle arthritis include pain or tenderness, swelling, and stiffness in the joint and limited range of motion.

Diagnosis of Foot and Ankle Arthritis

The diagnosis of foot and ankle arthritis is made with:
  • Medical history,
  • Physical examination, and
  • X-rays of the affected joint.
Further examination of the foot can be very important, particularly for subtle injuries which require a high index of suspicion.
  • A bone scan,
  • Computed tomography (CT) scans, and
  • Magnetic Resonance Imaging (MRI) scans are also performed to diagnose arthritis.

Treatment of Foot and Ankle Arthritis

Non-Surgical Treatment

Nonsurgical treatment options for foot and ankle arthritis include:
  • medications (anti-inflammatories), 
  • injections (steroids), 
  • physical therapy, 
  • an ankle-foot orthosis (AFO), 
  • weight loss, 
  • orthotics such as pads or arch supports, and 
  • canes or braces to support the joints. 

Surgical Treatment

Surgery may be required to treat foot and ankle arthritis if your symptoms do not get better with conservative treatments. Surgery performed for arthritis of the foot and ankle includes:

Arthroscopic Surgery:

Arthroscopy is a surgical procedure during which the internal structure of a joint is examined for diagnosis and treatment of problems inside the joint.

Arthroplasty or Joint Replacement:

In this procedure, the damaged ankle joint is removed and replaced with an artificial implant. It is usually performed when the joint is severely damaged by:
  • Osteoarthritis, 
  • Rheumatoid arthritis, or
  • Post-traumatic arthritis. 
The goal of ankle replacement is to relieve pain and restore the normal function of the ankle joint.

Treatment Process

Preparation for Surgery

  • Provide a complete list of your medications so you can be advises which to stopped prior to surgery,
  • Treat any tooth, gum, bladder or bowel problems before surgery to reduce the risk of infection
  • Stop anti-inflammatory medications (NSAIDs) at least seven days before the procedure.
  • Stop or cut down smoking to reduce your surgery risks and improve your recovery
  • Consider losing weight (if overweight) before surgery

Day of Surgery

  • Report any infections to me prior to surgery as the procedure cannot be performed until all infections have cleared up.
  • Do not consume alcohol - 24 hours prior to treatment,
  • Do not eat or drink anything, including water, for 6 hours before surgery
  • Avoid vigorous physical activity or exercise 24 hours prior to surgery,

During Surgery

  • Administration of general anesthesia or sedation and local anesthesia
  • The entire procedure can take 60 minutes to two hours.
  • Procedure is performed and sent to recovery room, for observation
  • Pain medications are prescribed to help with pain during the recovery phase. 
Arthroscopic Surgery
  • A small incision is made in the patient’s skin through which pencil-sized instruments that have a small lens and lighting system (arthroscope) are passed. 
  • Arthroscope magnifies and illuminates the structures of the joint with the light that is transmitted through fibre optics. 
  • It is attached to a television camera and the interior of the joint is seen on the television monitor.
  • Your surgeon can then use probes, forceps, knives, and shavers, to clean the joint area of foreign tissue, inflamed tissue, or bony outgrowths (spurs).
Arthroplasty or Joint Replacement
  • The surgeon removes the damaged ankle joint and replaces it with an artificial implant.

After Surgery

  • Do not consume large amounts of alcohol after surgery,
  • Avoid vigorous physical activity or exercise until advised,
  • Follow the Post Surgery Treatment Plan proscribed by the surgeon and post op care specialists.
  • Any questions or complications should be communicated directly to the surgeon

Common Questions

If you have a specific question about your treatment, we recommend contacting the clinic
  • Hospital Discharge?

    The patient is then discharged from the hospital in a day or two after the procedure. 


    Patients are advised on the steps to keep the wound dry and clean and on scar management.


    The patient is advised to maintain a strict elevation of the joint for ten days. 

    • arrange help to assist with chores, and
    • avoid putting any weight on the joint, with the help of crutches and walkers. 
  • Recovery After Ankle Arthritis?

    Patients are normally immobilised in a below-knee cast or boot for 6 weeks.


    Other conditions include:

    • no weight-bearing during this time, and 
    • often a further 4-6 weeks in a boot is required once walking is started. 

    Return to maximum function often takes up to one year after the injury.

  • Wound Management?

    At the time of discharge patients are advised on:

    • The necessary steps to keep the wound dry,
    • Wound care and Cleaning, and 
    • On scar management. precautions.
  • What if I Am Pregnant?

    It is not recommend surgery while pregnant, as the risks are uncertain due to the lack of information available about the effect on the fetus. 


    For more information please call us on and request to speak with one of our medically-trained registered doctor or nurse.

  • Post Surgery Treatment Program

    Long term outcomes depend on the severity of the initial injury. 


    Some patients won’t get back to their pre-injury function or sport, even with well-performed surgery. 


    Ten Days After Surgery

    X-rays are repeated ten days after the procedure to determine the situation. 


    Physiotherapy

    For the best possible outcome, postoperative physical therapy plays an important role in proper recovery following your procedure. 


    This postoperative management includes regular scheduled visits with a physical therapist 


    Extended Recovery Period

    The patient is advised to limit their activities for six to eight weeks after the surgery.


    Certain activities such as driving are also restricted for up to six weeks post-surgery. 

  • Possible Risks or Side Effects?

    The procedure carries all the risks associated with surgery, such as 

    • infection, 
    • bleeding and 
    • a severe allergic reaction to anesthesia. 

    Redness and bruising at the site of injection may be seen which should resolve over time. 


    You may experience post operative pain for prolonged period or other serious side effects contact your surgeon, as well as:

    • damage to the structures around the operative zone such as nerves, blood vessels, tendons, muscles,
    • chronic pain due to nerve entrapment
    • delayed healing
    • wound infection or breakdown.
  • Possible Complications of Surgery?

    If this condition or injury is missed or untreated can result in the collapse of the arch of the midfoot with significant pain, and the development of arthritis. 


    When surgery is performed, risks include damage to the structures around the top of the foot (nerves, blood vessels, tendons, muscles), as well as a risk of wound infection or breakdown.


    It is common to sustain cartilage damage at the joint surfaces during the initial injury, and some people develop midfoot arthritis and ongoing pain down the track. 


    Some patients require further surgery to fuse the midfoot joints to relieve arthritis pain.

  • Do You Offer Discounts?

    Due to strict regulations set by the Australian Medical Board it is against the law to offer surgical inducements. 


    Discounted treatments should raise alarm bells when you are choosing which specialist to trust your treatment to. 


    The surgeon's skill is more important than price. Effective surgery will maximise your health outcome.