Ankle
Ankle Osteoarthritis
About Your Condition
The ankle joint is formed between the tibia (shin bone) and the talus (ankle bone). Osteoarthritis occurs when the cartilage lining this joint wears away, leading to pain, stiffness, and swelling that typically worsens with activity. Unlike hip and knee arthritis, ankle arthritis is most commonly post-traumatic — arising after a previous fracture or ligament injury.
Symptoms include deep ankle pain with walking and standing, stiffness particularly in the morning or after rest, swelling around the ankle, and a gradual reduction in walking distance and tolerance.
Non-Operative Management
Non-operative management focuses on reducing joint load and managing symptomatic flares.
Footwear and Bracing
- A large, stiff-soled rocker-bottom shoe is the preferred footwear choice, as it substantially reduces ankle joint motion during walking and significantly decreases pain and load.
- Heel lifts can reduce the dorsiflexion demand on a stiff or painful ankle.
Activity Modification
- Swimming, cycling, seated exercise, and the cross-trainer or elliptical maintain fitness without significant ankle joint loading.
- Within the limits of your pain, walking is encouraged, though high-impact activity — running, jumping — should be avoided.
Corticosteroid Injection
- A cortisone injection into the ankle joint can be useful as a one-off during a painful flare, providing temporary relief of pain and swelling, though the benefit varies and it does not alter the underlying arthritis.
- It is not a useful long-term solution for end-stage arthritis, and is not repeated indefinitely. If total ankle replacement is being considered, an injection should not be given too close to the planned surgery date, as this can increase the risk of infection around the implant.
When to Consider Surgery
Surgery is considered when symptoms significantly limit your daily activities — including work, leisure, or exercise — despite an adequate trial of non-operative treatment. The aim is to restore function and improve your quality of life, so you can continue to undertake the activities you enjoy.
Two well-established surgical options are available: Total Ankle Replacement, which preserves joint motion and may feel more natural, and Ankle Arthrodesis (Fusion), which eliminates the joint and is more durable with a lower reoperation rate. Both are effective procedures with high patient satisfaction — the choice depends on your age, activity level, bone quality, alignment, and the pattern of arthritis, and is made jointly with Dr Hogan.