Surgical management of ankle arthritis depends on many factors, including:
- The location and size of cartilage loss in the ankle
- Patient age, weight, and expected activity level
- Condition of the skin, nerves, tendons, and bone around the ankle
- The response to previous treatment
- Other medical problems
Patients with small cartilage problems or spurs around the ankle can benefit from arthroscopy. During the procedure, a pencil-sized camera and small instruments are inserted through a few half-inch incisions around the ankle to visualize and treat the problem. The patient usually goes home the day of surgery and can start some limited walking with the help of crutches within a few days.
Ankle joint distraction is a surgical alternative in younger patients with advanced ankle arthritis. It is typically not a definative treatment but used instead to ‘buy time’ for patients who are too young for an ankle replacement or fusion. Clinical shows have shown that the majority of patients who have this procedure experience a progressive improvement of function and relief of pain that continues to improve with time.
Ankle fusion is a surgical technique to reduce the pain associated with ankle arthritis by getting the bones around the ankle to grow together. The surgery requires the removal of the joint cartilage, proper positioning of the ankle and foot, and placement of screws, plates, rods, or pins to hold the position while the bone knits together into a solid painless structure.
ANKLE JOINT RESURFACING
Patients with large and well-localized cartilage and bone loss may benefit from resurfacing of the bad part of the joint. The joint is usually evaluated with an arthroscopic camera and then the region involved is resurfaced. Most commonly "plugs" of cartilage and bone are removed from a part of the knee and placed into these areas.
In the past 10 years, ankle joint replacements have become a good treatment option for advanced ankle arthritis in many patients. New joint replacements (prostheses) have become available that last longer and provide good pain relief. An ankle joint replacement has the advantage that it cures the problem of arthritis in the ankle but does not sacrifice motion.