Osteoarthritis of the ankle joint

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This may rarely occur as a primary disorder; however, degenerative arthritis of the ankle joint is more commonly secondary to recurrent episodes of trauma from lateral ligament instability or from the sequelae of intra-articular fractures involving the ankle joint. It may also occur as a secondary phenomenon to avascular necrosis of the talar dome secondary to talar neck fractures. The long-term outcome of septic arthritis of the ankle joint which damages the articular cartilage may be degenerative osteoarthrosis.

The presenting symptoms and signs are usually pain, swelling and stiffness of the joint. The pain is markedly exacerbated by weight bearing. Restriction of movement usually affects dorsiflexion.

Initial treatment usually revolves around conservative measures (i.e. walking aids, supportive footwear, analgesics, anti-inflammatory agents and physiotherapy). If these fail, injection of intra-articular anaesthetic and steroid may be considered to give temporary symptomatic relief and operative treatment may be necessary. This usually takes the form of an ankle joint arthrodesis which relieves pain effectively but permanently stiffens the joint.

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