Arthritis of the Foot & Ankle
What is Foot and Ankle Arthritis?
Arthritis is the inflammation of joints as a result of degeneration of the smooth cartilage that lines the ends of bones in a joint. This degeneration of the cartilages leads to painful rubbing of the bones, swelling, and stiffness in the joints, resulting in restricted movements. Arthritis in the foot and ankle can occur due to fractures, dislocation, inflammatory disease, or congenital deformity. The foot joints most commonly affected by arthritis are:
- The joint between the shinbone (tibia) and ankle bone (talus)
- The three joints of the foot that include the heel bone, the inner mid-foot bone, and the outer mid-foot bone
- The joint of the great toe and foot bone
What are the Types of Foot and Ankle Arthritis?
There are three types of arthritis that can affect the foot and ankle:
- Osteoarthritis: Also called degenerative joint disease, this is the most common type of arthritis and occurs most often in the elderly. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge or stick out at the end of a joint (bone spurs).
- Rheumatoid arthritis: This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, and loss of function in the joints. Rheumatoid arthritis mostly affects the joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (both feet) at the same time and with the same symptoms.
- Post-traumatic arthritis: Arthritis that develops following an ankle or foot injury is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain or ligament tear.
What are the Common Causes of Foot and Ankle Arthritis?
Osteoarthritis occurs as a result of old age. Rheumatoid arthritis is often caused when the genes responsible for the disease are triggered by an infection or environmental factor. This triggers the body to produce antibodies, the defense mechanism of the body, against the joint. Fractures at joint surfaces and joint dislocations may predispose an individual to develop post-traumatic arthritis. The body secretes certain hormones following an injury which may cause death of the cartilage cells.
What are the Symptoms of Foot and Ankle Arthritis?
The symptoms of foot and ankle arthritis include pain or tenderness, swelling, stiffness in the joint and limited range of motion.
How is Foot and Ankle Arthritis Diagnosed?
The diagnosis of foot and ankle arthritis is made with a medical history, physical examination and X-rays of the affected joint. A bone scan, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans are also performed to diagnose arthritis.
What are the Treatment Options for Foot and Ankle Arthritis?
Non-surgical treatment options for foot and ankle arthritis include:
- Medications (anti-inflammatories)
- Injections (steroids)
- Physical therapy
- Ankle-foot orthosis (AFO)
- Weight loss
- Orthotics such as pads or arch supports
- Canes or braces to support the joints
Surgery may be required to treat foot and ankle arthritis if your symptoms do not improve with conservative treatments. They may include:
- Arthroscopic surgery: Arthroscopy is a surgical procedure during which an arthroscope – a narrow lighted fiber-optic tube with a camera attached – is inserted into the joint through a key-hole incision. The arthroscope provides your surgeon with a large real-time image of the injury on a monitor for clear a view. The internal structures of the joint are examined for diagnosis and your surgeon can treat the problem as well with small surgical instruments passed through 2 – 3 small incisions. Your surgeon uses probes, forceps, knives, and shavers to clean the joint area of foreign tissue, inflamed tissue or bony outgrowths (spurs). Once the surgery is complete, the incisions are closed.
- Arthroplasty or joint replacement: In this procedure, your surgeon removes the damaged joint and replaces it with an artificial implant. It is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis or post-traumatic arthritis. The goal of joint replacement is to relieve pain and restore its normal function.