Post Traumatic Ankle Arthritis
Post Traumatic Ankle Arthritis is special type of accelerated wear and tear arthritis typically causing chronic ankle pain. This type of arthritis in the ankle is a chief complaint of many of our patients at The Florida Center for Foot and Ankle Reconstruction.
Dr. Michael R. Black provides information below about the cause of post traumatic ankle arthritis, symptoms, and treatment. Dr. Black also discusses new FDA-approved alternatives to ankle fusion for post traumatic ankle arthritis patients.
Cause of Post Traumatic Ankle Arthritis
Traumatic ankle injuries, namely fractures, can lead to the loss of joint congruity. We know that as little of 1 mm of displacement of the talus within the ankle joint can lead to a 40% increase in joint contact pressures. More force per unit area means that cartilage will wear away at an accelerated rate.
Thus, one of the goals of ankle fracture surgery is to realign the joint surfaces and to restore the anatomic alignment of the ankle joint.
Deformities of the ankle such as Ankle Valgus, Ankle Varus, Tibial Recurvatum and Tibial Procurvatum can result after traumatic injury. The more severe the deformity, the faster arthritis in the ankle will occur.
In addition to malalignment following trauma, sheer and crush forces at the time of the initial injury can cause injury to the joint cartilage. Cartilage does not have the vascularity that bones do and therefore does not repair itself the way bones can mend themselves. The death of cartilage leads to degenerative change that usually occurs slowly over time contributing to arthritis in the ankle and chronic ankle pain.
Post Traumatic Ankle Arthritis Symptoms
Chronic ankle pain is the most common complaint from patients. Other post traumatic ankle arthritis symptoms include:
Grinding or clicking sensations arising from the ankle
Pain in the adjacent joints such as the knee or subtalar joints
Arch collapse or increased arch height, changes in foot alignment or appearance
Difficulty finding comfortable shoes.
Activities which patients may find difficult include: walking, running, going up or down stairs, court activities such as tennis or racquetball or other high impact activities, as well as, walking on uneven surfaces – like the beach.
Xrays are the mainstay of diagnostic testing. This allows the surgeon to assess the degree of arthritis in the ankle and measure any deformities that may have an impact on the prognosis or potential treatment options.
CT scans, MRI, bone scans are sometimes ordered by the surgeon to better evaluate the integrity of the subchondral bone, cartilage, ligaments and tendons or to rule out infection.
Post Traumatic Ankle Arthritis Treatment
Ankle Fusion for Post Traumatic Ankle Arthritis treatment used to be the gold standard. However, this is beginning to change with the arrival of newer generation ankle joint replacement prostheses, including the STAR ankle.
If there is deformity present and the arthritis is not advanced, realignment procedures can be performed to spare the joint. These are intended to improve motion, reduce joint contact pressures and buy the patient time until fusion or replacement.
There are other options for less severe arthritis in the ankle - treatment may include ankle joint arthroscopy, corticosteroid injections, Viscosupplementation, ankle joint distraction with an external fixator, and bracing for non-surgical candidates.
Find out if your chronic ankle pain
is the result of Post Traumatic Ankle Arthritis.
Schedule an Appointment Today for your consultation.
Dr. Black is happy to discuss surgical and non-surgical solutions.