Foot & Ankle Arthritis
Anatomy: The foot and ankle have complex bony anatomy.
Injury: Arthritis may occur from overuse or may occur after trauma or fracture.
Diagnosis: X-rays are the best means of diagnosing arthritis of the ankle and foot. MRI can be a valuable adjunct in diagnosing arthritis of some of the smaller joints of the foot.
Treatment
- Protected Weight Bearing: A short period of partial weight bearing using two crutches (a cane is inadequate) or a walker is invaluable. Arthritic joints crave decrease weight bearing and acute pain subsides almost immediately when this is done. It is also very important to avoid pain or anti-inflammatory pills (e.g. advil, motrin, aleve) because they mask pain and allow worsening with the patient being unaware. They also interfere with healing and have dangerous side effects. If weight bearing is restricted and pain medicines, as well as pain creams, pain patches, ice and other modalities that mask pain are also avoided, your body will tell you when you can again increase your weight bearing. In many cases this all that is necessary. Cortisone injections should also be avoided as their results are usually temporary and they help accelerate joint degeneration
- PRP-STEM Cell Injection: If pain persists, PRP or stem cell injection in our hands has a high rate of success for arthritis of the ankle, foot and Great toe. With thousands of injections performed we are one of the most experienced Orthopaedic Centers in the world in the use of this treatment.
- Surgical Treatment: Surgical treatment of arthritis is generally not effective in relieving pain unless surgical joint fusion is performed. While joint fusion can be an effective salvage procedure if non-surgical treatment fails, it permanently eliminates motion of the joint and can result in pain from transfer of stresses to adjacent joints. Foot and ankle joint replacement surgery has a lower success rate and higher complication rate than knee and hip replacement. In fact I had one patient who I treated for a different problem who had failed ankle replacement elsewhere followed by failed ankle fusion elsewhere who eventually had to have below knee amputation of her leg to regain the ability to walk. This is a rare complication, but she is not the only one who has had it.
