Ankle pain can be very difficult for a patient to describe to their physician.   It is also very difficult for general practitioners to adequately diagnose  ankle arthritis if they are not proficient in performing an ankle and foot examination.  Ankle arthritis will cause pain with dorsiflexion (moving foot upwards) and plantar flexion (moving foot downwards)  due to the bone spurs that form around the ankle joint.  The more severe the arthritis becomes, the more cartilage will erode and you will end up with “bone on bone”.  When cartilage is destroyed, it cannot be “repaired” and bone articulating on bone will create more pain and inflammation.  The longer this occurs the more irreversible the damage to the joint becomes.

Early treatment can consist of cortisone injections into the joint to reduce the soft tissue inflammation that occurs in the initial stages of arthritis.  If injections fail and the condition continues to worsen, ankle arthroscopy to clean out the soft tissue inflammation and synovitis as well as any bony fragments that may be within the joint.

When conservative treatment fails, fusing the ankle joint is the next step.  This is performed to stop motion to the ankle joint and reduce pain.  While one would think the motion is needed to walk normal, pain from the grinding and limited mobility will be worse in regards to trying to walk normal.  Many patients resume normal walking after the joint is fused compared to how they were walking prior to the surgery with pain and limping from the arthritis.