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Dr. Baravarian discusses ankle arthritis and the advanced treatment options available.
What's ankle arthritis?
Ankle arthritis, a form of osteoarthritis, is a degenerative condition in which the cartilage and ligaments of the ankle joint wear thin and eventually break down.
Without cartilage to cushion and protect the bones from the friction of motion, bone fragments and spurs develop, causing joint pain and stiffness.
Ankle arthritis is a progressive degenerative disease; however, receiving treatment promptly can help preserve joint function and prevent permanent damage.
What are the causes of ankle arthritis?
Understanding the cause of your ankle arthritis can help Dr. Bob prescribe the right course of treatment for you.
The major types of arthritis that affect the ankle are:
What’s post-traumatic arthritis
A previous sprain or fracture can increase the risk of developing arthritis in the ankle. An ankle that has been subject to some trauma is around seven times more likely to develop arthritis.
As many as 80% of ankle arthritis cases can be classified as “post-traumatic arthritis.” Although the original ankle fracture or sprain may have healed, physiological changes can occur in the ankle to compensate for the injury, resulting in osteoarthritis several years later.
Underlying medical conditions
Between 10-15% of cases of ankle arthritis are caused by an underlying medical condition or autoimmune disease, such as rheumatoid arthritis, congenital structural defects, blood disorders, and conditions that cause poor circulation.
Although many aging adults dismiss ankle pain as another sign of “old age” or an old injury “acting up,” it’s important to seek help for chronic ankle pain. Several treatment options can slow the progress of ankle arthritis, relieve pain, and keep patients on their feet through their golden years.
What are the symptoms of ankle arthritis?
Symptoms usually develop gradually and worsen with time and overuse. They include:
- Pain in the ankle, lower shin, mid-foot, or rearfoot. It can be dull or acute and chronic or intermittent.
- Joint pain after daily activity. Walking or jogging can cause pain and swelling in the joint.
- Swelling. As the cartilage wears thin, friction caused by regular ankle motion irritates the joint, causing swelling and discomfort.
- Stiffness. The increased friction between bones can stiffen the joint, making simple foot functions like pointing and flexing the toes more difficult. The stiffness tends to worsen after long periods of inactivity.
How does Dr. Bob Baravarian diagnose ankle arthritis?
Arthritis can be diagnosed with a full medical history, a physical exam, and advanced imaging technology. Dr. Bob will examine your ankle for swelling, tenderness, joint damage, and bone spurs, and evaluate your range of motion.
Typically, one or more of the following imaging tests are performed to confirm an osteoarthritis diagnosis:
X-ray and radiography
Although an X-ray can reveal signs of joint damage, it is not the most reliable indicator of osteoarthritis. However, it can aid in making a diagnosis along with a physical examination.
MRI
An MRI (magnetic resonance imaging) can provide a more complete picture of the location and degree of cartilage loss.
3D pedCAT
The pedCAT is a weight-bearing CT scanning machine that produces a 3D image and allows your specialist to identify points of stress on your ankle while standing. Dr. Bob’s clinic is one of only a handful of clinics in California with pedCAT technology.
What are the treatments for ankle arthritis?
The goal of ankle arthritis treatment is to maintain joint motion and provide long-term pain relief using the least invasive option possible. Non-operative treatment options can sometimes “buy time” for younger patients and put off treating the ankle with a more invasive option until the future.
Non-surgical treatments for ankle arthritis
Depending on your symptoms and what’s causing your arthritis, we might suggest one or more of these treatments:
- Steroid injections in the affected joints.
- Over-the-counter medications like ibuprofen (Advil) and naproxen (Aleve), as well as prescription nonsteroidal anti-inflammatory drugs (NSAIDs), can help relieve pain and swelling.
- Pads or arch supports in your shoes.
- Canes or braces for support.
- Shoe inserts (orthotics) that support your ankle and foot.
- PT: Dr. Bob may recommend physical therapy, helping to maintain strong and flexible muscles for as long as possible.
- Custom-fitted shoes.
- Reduce high-impact activities to reduce stress on your joints.
Regenerative therapy: stem cell and PRP therapy
Regenerative medicine prompts the body to heal itself and offers many patients the best chance at improving long-term ankle function and joint restoration. Dr. Bob performs either stem cell therapy or platelet-rich plasma therapy, or a combination of both. Both treatments are minimally invasive and can be used as an alternative or addition to surgery.
Stem cell injections utilize the patient’s own cells to stimulate the body’s natural healing process and regenerate tissue. The stem cells replicate themselves, and nearby cells start to mimic them, promoting healing and producing an anti-inflammatory effect that can help reduce pain. Stem cell injections also contain hyaluronic acid, which lubricates joints and tendons, further easing pain and helping restore mobility.
Regenerative medicine is not a steroid injection. Corticosteroids suppress the body’s immune response, which is why steroid injections mixed with an anesthetic can be used to reduce inflammation and pain in arthritic joints. However, this relief is typically short-lived and needs to be re-administered every three to four months. Long-term steroid use can further weaken cartilage and soft tissue.
What are the surgical options for ankle arthritis?
When ankle arthritis is severe, advanced, or not responding to more conservative treatments, surgery is often considered. Dr. Bob Baravarian is trained in a wide range of surgical techniques to help relieve your ankle arthritis.
Minimally invasive ankle arthroscopic surgery
This type of surgery cleans up the ankle joint, debriding scar tissue, damaged cartilage, loose cartilage, bone fragments, and bone spurs. Removing the damaged tissue or bone allows for restored mobility and decreased pain for your active life. It is generally performed on an outpatient basis.
Ankle arthroscopy is performed through two or three tiny incisions on the ankle. Dr. Bob inserts tools and removes tissue through the small incisions, guided by a lighted camera. Stem cell therapy can be used in conjunction with ankle surgery to speed up the recovery process.
Ankle Arthrodiastasis
Often effective for severe arthritis, arthrodiastasis uses an external fixator to allow the ankle joint to repair itself. Arthrodiastasis is sometimes done in combination with ankle arthroscopy to clean out the joint, as well as stem cell therapy to help produce healthy tissue.
Ankle joint replacement surgery
Total ankle replacement or ankle arthroplasty replaces the joint surfaces of the arthritic ankle with an artificial implant. Advances in biomedical technology have developed multiple types of implants to address individual patients’ needs.
Choosing the best arthroplasty implant design for each patient is the first step toward a successful outcome. Dr. Bob has extensive experience in all three types of ankle replacement surgery. This enables him to tailor treatment to the best interests of each patient.
Ankle Fusion
Ankle fusion, also known as arthrodesis, is a surgical technique reserved for treating severe end-stage ankle arthritis. Dr. Baravarian prefers to explore all options before undergoing any surgical procedure, and prides himself in avoiding fusion, if possible.
Ankle fusion is considered a joint-destructive procedure, meaning the patient will no longer have mobility in the joint. While this may sound extreme, patients with end-stage arthritis generally have already lost almost all ankle motion before treatment. Fusion can provide the ankle with stability and significantly reduce arthritis pain by immobilizing the joint.
Dr. Bob Baravarian, the best choice for ankle arthritis treatment in Los Angeles
When you choose Dr. Bob Baravarian, you will quickly discover that you have chosen a compassionate healthcare expert with decades of experience. His team of physicians uses state-of-the-art equipment, works directly with medical manufacturers to develop new technologies, and is one of the few foot and ankle practices in the nation that offer the latest treatment options for all stages of ankle arthritis.
To schedule a consultation, please call (855) 557-5400 or make an appointment now.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
Ankle Arthritis FAQs
What are the risk factors associated with ankle arthritis?
Arthritis is often associated with aging. Other risk factors for ankle arthritis include joint injury, obesity, and anatomic factors such as joint shape and alignment.
Is walking good for ankle arthritis?
Yes, walking can be beneficial for ankle arthritis as it helps maintain joint mobility and strengthens the surrounding muscles, which can support the affected joint. However, it’s important to consult with a foot and ankle specialist to determine the appropriate level of activity and any modifications needed to manage ankle arthritis effectively.
Can you also get arthritis in your big toe?
Yes, hallux rigidus is a form of arthritis that affects the big toe joint.
What is inflammatory arthritis?
Inflammatory arthritis is a category of autoimmune diseases. Conditions like rheumatoid arthritis and ankylosing spondylitis fall under this category, where the immune system mistakenly attacks the body’s own tissues, primarily affecting the joints.
What is psoriatic arthritis?
Psoriatic arthritis is a type of inflammatory arthritis that often accompanies the skin condition psoriasis.
What joints does ankle arthritis affect?
Ankle arthritis affects the tibiotalar joint, which forms between the shin bone (tibia) and ankle bone (talus).
Sources
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Arthritis of the foot and ankle
https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-foot-and-ankle/
