Arthritis is a general term that relates to pain, stiffness and swelling of joints, including in the ankle and the toes. As the cartilage lining that protects your joint is worn down, the bone ends rub on each other, causing increased pain and discomfort and swelling of the joint capsule.
It often comes with age and is a result of joint space narrowing and repetitive” wear and tear.” Other causes could be related to abnormal bone shape or position from birth (congenital) or from a traumatic incident. Diagnosing arthritis entails a medical history, a gait analysis where walking is analyzed and often some imaging tests which could be a MRI, CT scan, or X-ray.
Ankle arthroscopy can be very successful in treating patients with ankle pain and can be used to treat sports injuries, scar lesions in the joint, cartilage and bone injuries in the joint, mild arthritis and more. Ankle arthroscopy can also be used to assist in ligament reconstruction for those with unstable ankles as well as patients with fractures that affect the ankle joint.
Typically just two small incisions are made on the front of the ankle are needed to address most problems. Most ankle arthroscopy procedures are performed on an outpatient basis, and patients can often walk as tolerated after the procedure. Most procedures are done with a nerve block. This means patients are awake and alert during the procedure and it has lasting effects keeping them pain free for one to three days after surgery.
Ankle Joint Distraction
A technique popularized in the Netherlands, has gained increased use in the United States for distracting the joint allowing for nourishment of the cartilage and promoting the increase in blood supply to the joint for healing. It is commonly offered to patients with ankle arthritis, yet can be used for subtalar joint arthritis and great toe arthritis as well. The goal is preserve the joint and offer pain relief to the patient while allowing the cartilage to repair itself. This process requires the use of an External Fixator device for approximately 12 weeks, yet has provided long lasting relief for patients of all ages. In addition, the patient may be completely ambulatory and permitted to shower during the entire process.
Joint Replacement for Arthritis
Total Ankle Arthroplasty, more commonly known as a joint replacement, is an exciting option for the treatment of ankle arthritis. Like artificial hips and knees, this operation replaces both sides of the joint with metal parts, and a plastic spacer is placed between the metal parts to allow movement.
The technology, engineering, and understanding of the ankle joint have advanced considerably, and today's implants are much more durable. Ankle replacement offers the potential for pain relief, improved function, and protection of the surrounding joints from the additional stress that comes with a joint fusion, the previous standard for treating ankle arthritis.
Total ankle replacements are not for everyone. Younger and very active patients may do better with a fusion because a replacement may wear out too fast. Patients with severe deformities or prior infection may also be better served with an ankle fusion.
At the University of Maryland, we have the expertise to give you an honest assessment of your disease and the best treatment for you. We have experience with all the current total ankle replacements and can choose the implant that best suits your individual needs.
One of the many benefits of receiving your care at the University of Maryland Rehabilitation & Orthopaedics Institute, formerly Kernan Hospital, is state-of-the-art anesthesia and pain management. Our anesthesiologists are the experts in regional blocks, utilizing advanced ultrasound technology to guide placement of the medicine. Using a technique that numbs your leg from the knee down, you will need minimal narcotic medicines and have light sedation for the surgery. Afterwards, the nerve block may keep you pain free for up to several days after surgery, sometime using a small catheter to drip the medicine over time. This technique minimizes the other medications needed for surgery, resulting in less pain, less need for narcotic pain medication, less nausea and quicker recovery than general anesthesia.
For more information about regional anesthesia, please contact our office or view the Anesthesia Web site for University of Maryland Rehabilitation & Orthopaedics Institute, formerly Kernan Hospital.