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Foot, Ankle & Knee
Treating Ankle Arthritis
Ankle arthritis is a particularly troublesome
condition for greater than 700,000 Americans. Patients are quite
disabled with this condition because it can severely restrict
one's mobility. In addition, arthritis of the ankle can be difficult
to treat. Arthritis of the ankle joint is commonly associated
with a history of ankle injury. Ankle fractures and ankle sprains
are common ankle injuries, and can lead to arthritis if inappropriately
managed. However, arthritis can occur in the ankle without any
history of trauma. Symptoms of ankle arthritis consist of pain
with walking, ankle stiffness, ankle swelling, ankle "giving-way",
and ankle "catching". Often, patients with ankle arthritis will
have difficulty walking on uneven ground surfaces. Pain at night
is often very troubling and patients have difficulty sleeping
from time to time.
How is ankle arthritis treated?
Medication
We now have an exciting array of powerful anti-inflammatory
medications with greatly diminished side-effect profiles. These
new medications are quite effective when used in conjunction
with one of our ankle immobilization/support modalities.
Ankle immobilization
The first line of treatment for patients with ankle arthritis
is immobilization. We have several modalities of immobilization
to chose form. Our particular choice varies from case to case.
A very popular modality is the custom ankle-foot orthosis which
reduces or eliminates ankle symptoms by decreasing ankle inflammation
and mechanical impingement. This modality is quite effective
when prescribed in conjunction with one of the newer anti-inflammatory
agents.
Diagnostic and Therapeutic Arthrocentesis
We have used a highly effective protocol involving foot and
ankle arthrocentesis using local anesthetic with or without
adjunctive glucocorticiods. This modality is also particularly
effective with the use of an ankle foot orthosis.
Ankle Replacement vs. Ankle Fusion
Ankle fusion has been the mainstay of treatment for patients
who fail non-operative therapy. However, the treatment for ankle
arthritis is advancing very quickly. We are pleased to make
available to our patients a state-of-the-art total ankle replacement
system. Ankle replacement surgery has become highly successful.
Ankle replacement has many advantages over ankle fusion. However,
ankle replacement surgery is technically demanding and is performed
at only select centers. We recommend ankle replacement to our
patients who are appropriate candidates after careful and detailed
interview and examination.
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