Osteoarthritis (OA) is less common in the ankle than in the hip or knee. There may be an underlying cause such as previous injury, or it may occur “spontaneously”, but the end result is wear of the cartilage with spurs or “osteophytes” at the margins of the joint.

The symptoms of ankle arthritis include pain, swelling, stiffness and gradual loss of function. The symptoms are usually worse during or after “weight-bearing activity”, but in severe cases pain can disturb sleep at night. An x-ray is necessary to confirm the diagnosis and occasionally scans, such as CT or MRI, or a diagnostic injection are required.

Non-operative treatment is always recommended first and measures such as weight loss, activity modification, painkillers, braces or splints and joint injection are often effective. Surgery is only advised after the failure of these or other conservative measures. Arthritis progresses in stages and early on, arthroscopic (keyhole) surgery may be appropriate. However, when the arthritis is more advanced, you may require more major surgery, namely a Total Ankle Replacement (TAR) or Ankle Arthrodesis (“Fusion”).

With a TAR, the ankle joint is removed and replaced with an artificial joint, whereas an Arthrodesis operation involves removing the joint and fusing the two surfaces together. Both are major procedures and have their individual pros and cons, but are similarly successful for pain relief.