Wright Medical Group

Treatment of Arthritis

Different types of treatments are available for relief of arthritis pain and range from non-surgical to surgical options. Only a doctor can prescribe what is the right treatment option for you, but the graphic below details some of the options that he/she may discuss with you.

NON-SURGICAL OPTIONS
These conservative techniques are often used to treat early stage or non-severe arthritis.

Pain Medication – often doctors will prescribe nonsteroidal antiinflammatory drugs to reduce swelling and help relieve pain.

Shoes and inserts – pads, arch supports or even custom-made stiff-soled shoes with rocker bottoms can help make walking more comfortable.

AFO – ankle-foot orthosis – A brace (usually plastic) worn on the lower leg and foot to support the ankle, hold the foot and ankle in the correct position, and correct foot-drop.

Injections – symptoms can be markedly improved by the injection of a steroid into the joint. However, this can have a negative long-term effect on the joint.

SURGICAL OPTIONS
If arthritis does not respond to the conservative non-surgical treatments, surgery may be an option. An average of 65,000 U.S. patients undergo ankle surgery each year1. The decision to treat ankle arthritis surgically is based on many factors including:

  • The location of the cartilage loss in the ankle
  • Patient age, weight and expected activity level
  • Condition of the skin, nerves, tendons and bone around the ankle
  • Response to previous treatment
  • Other medical problems

The primary surgeries performed for arthritis of the ankle are:

Arthroplasty, or Total Ankle Replacement – A relatively new, patient-friendly alternative to ankle fusion. Ankle replacement involves resurfacing the ankle joint with artificial implant parts that allow continued motion and function of the ankle joint, without pain.

Arthroscopic debridement – Helpful in the early stages of arthritis development, this procedure involves insertion of a pencil-sized camera and small instruments into the joint to visualize and remove foreign tissue and bony outgrowths (spurs).

Ankle fusion – Once the only treatment for end-stage ankle arthritis, this procedure eliminates pain by eliminating joint motion. During the process, the cartilage is removed and the bones are pinned together with screws, plates, rods, or pins. Eventually the bones grow together in one solid mass.

1 References: iData Research Inc., 2008. Foot and Ankle Reconstruction Market

You don’t need a physician to know your ankle hurts. But, you do need one to determine why and what to do about it. If you don’t have a physician, we can help you find one here.

If you have end-stage ankle arthritis, you may experience chronic:

  • Tenderness or pain
  • Reduced ability to move, walk, or bear weight
  • Stiffness in the joint
  • Swelling in the joint

To diagnose the root cause of your ankle pain, your physician will conduct a physical exam. You can also expect questions about your pain, activities, and medical history. Depending on the findings, your physician may request imaging tests and lab work.

Imaging tests may include an X-ray. This will show your physician the space between the bones, bony growths, and any fractures. A computerized tomography (CT) scan or bone scan may be used to identify fractures not visible on X-ray. Your physician may request magnetic resonance imaging (MRI) to visualize the bones and soft tissues.

Lab tests may include a blood and/or joint fluid sample. Test results may provide important clues. For example, high levels of rheumatoid factor may indicate rheumatoid arthritis. High levels of antinuclear antibodies could suggest lupus or another inflammatory disease.

For most physicians, the first line of treatment for chronic, severe ankle arthritis pain is nonsurgical. Treatment often includes limiting activities that may irritate your ankle joint.

Your physician may also recommend shoe inserts (orthotics), an ankle brace, or a cane. Another option is a custom-made shoe with a stiff sole and a rocker bottom called an ankle-foot orthosis (AFO).

Medications may also be part of your treatment. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen may reduce inflammation and pain. Injections, such as cortisone, may also provide pain relief.

Your physician may advise you to lose weight if you are overweight. Increased weight increases the downward force on the joint. Reaching and maintaining a healthy weight reduces pressure and irritation on the joint.

Debridement may be an option

If bone spurs, loose pieces of cartilage, or inflamed tissue are causing your ankle pain, your physician may recommend debridement. This is a minimally-invasive surgery that uses micro-instruments and a camera to clean your joint.

If these treatments do not provide relief, surgical intervention may be an option. Speak with your doctor to see if you are a candidate for ankle replacement.