Arthritis encompasses various conditions leading to the breakdown of joint cartilage, similar to tire wear on a car. Joint cartilage loss results in painful movement and swelling. While arthritis can affect any joint, ankle arthritis commonly arises from prior injuries or conditions such as osteoarthritis and rheumatoid arthritis.

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Symptoms

Patients with ankle arthritis typically experience swelling, stiffness, and pain, often preceding visible symptoms. These may manifest gradually or suddenly, accompanied by difficulties in standing or walking, especially on uneven surfaces. Advanced cases may alter foot alignment or positioning without immediate recognition. Symptoms may fluctuate, worsening or improving based on activity levels and other factors.

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Causes

Most frequently, ankle arthritis stems from prior injuries. Mentioning any past ankle or foot injuries to your doctor is crucial, even those from childhood or many years ago. Additional causes include osteoarthritis, rheumatoid arthritis, and infection, among others. Consulting a foot and ankle orthopedic surgeon is advisable to determine the underlying cause of ankle arthritis.

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Diagnosis

Ankle arthritis is typically diagnosed through weightbearing X-rays, illustrating ankle and foot alignment and joint cartilage loss. In severe cases, X-rays may reveal a "bone-on-bone" condition, indicating significant cartilage degeneration. Additional imaging like CT scans or MRIs may be requested for comprehensive evaluation or treatment planning.

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Treatment

Treatment focuses on pain management and joint deformity mitigation. Non-surgical approaches are generally initial steps and may include:

• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) alleviate inflammation and pain either orally or as topical gels.

• Bracing: Ankle braces restrict joint motion, potentially preventing further damage and reducing pain.

• Activity Modification: Adjusting activities to minimize stress on the ankles, favoring low-impact exercises like cycling and swimming.

• Physical Therapy: Strengthening ankle stabilizing muscles, particularly beneficial in early arthritis stages when combined with activity modification.

• Injections: Steroid injections may provide temporary pain relief, although long-term efficacy varies. An alternative injection like platelet-rich plasma (PRP)  can be also effective for ankle arthritis, depending on the severity.

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Surgical Treatment

If non-surgical interventions fail to alleviate symptoms, surgical options may be considered, tailored to arthritis severity. Minor surgeries involve removing bone spurs or repairing small cartilage defects. For advanced cases, total ankle replacement or ankle fusion may be recommended. Ankle replacement entails replacing worn areas with metal and plastic components, while an ankle fusion involves bonding ankle bones using plates and screws. Other procedures may realign the ankle in addition to addressing arthritis.

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Recovery

Recovery duration varies based on surgical complexity, ranging from several months for minor surgeries to a year or more for ankle replacement or fusion. 

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Prevention

Managing arthritis proactively involves early treatment to control pain, minimize joint damage, and potentially avoid surgery. Maintaining a healthy lifestyle with low-impact exercises and consulting a doctor before significant lifestyle changes are advisable. The decision to have surgery is an individual one. Surgery should only be considered if non-surgical treatment options are unsuccessful. The type of surgery depends upon the severity of the arthritis and the patient's individual goals.