Ankle joint arthrosis

Optimum treatment to move your foot smoothly again

The ankle joint consists of three bones, one joint and copes with, on average, 3000-4000 steps per day. If you are experiencing pain, cartilage wear, known as ankle joint arthrosis, may be responsible.

Our specialists at Schoen Clinic have completed intensive research into ankle joint arthrosis and are able to offer you the best possible treatment to increase movement, reduce pain and improved your quality of life.

How is the ankle joint constructed?

Your ankle joint sits between your lower leg and your foot. It is divided into the upper and lower ankle joint. The upper ankle joint is made up of three bones: the shin bone, the fibula and the ankle bone. To prevent the bones involved from rubbing painfully against each other with every movement and injuring each other, their contact surface within the joint is covered with a smooth, elastic cartilage layer. If this protective “shock absorber” is lost, your bones get closer to each other, the joint cavity becomes narrower i.e. joint wear or arthrosis in the ankle joint.

Signs & symptoms of arthrosis

  • Stiffness in the ankle
  • Pain with motion
  • Pain which increases with rigorous activity
  • Swelling or inflammation
  • Increased pain after periods of rest
  • Feeling of instability in the joint

Accurate Diagnosis for the perfect treatment

Your specialist will carry out a comprehensive medical history with you during your consultation, detailing any previous accidents with bone fractures, unstable ligaments or inflammatory joint disorders. A physical examination will be undertaken to assess any tenderness or swelling in your ankle and observeation of your gait, will most likely be required. This will determine how pain or joint stiffness is affected while you walk. Should you require any imaging following your physical examination, Schoen Clinic London has a dedicated imaging and diagnostics suite, with state-of-the-art equipment to assist in further investigations.

Following examination and precise diagnosis, we will suggest the ideal treatment plan for you.

Proven methods: X-Ray and MRI

X-ray images make it possible for us to see the joint cavity. Carrying out an X-ray while the patient is standing allows us to produce images in two planes under a load. This helps to determine the precise stage of the ankle arthrosis as we can measure the distance between the individual bones of the joint. The narrower the joint space, the more likely a large amount of the cartilage has been damaged or worn away. X-rays also make it possible to see bone spurs, which have a negative impact on your condition and in turn can affect your quality of life.

In some instances, Magnetic Resonance Imaging (MRI) may be required to better evaluate your joint cartilage. MRI scans also make it possible to identify potential damage to your tendons and ligaments. In order to better show any deformities there might be in the joint, we are able to perform a CT scan. Your bone is shown more precisely here than with an X-ray or MRI.

Should there be any suspicion of rheumatism or pronounced signs of inflammation, a blood test can be undertaken to further clarify the cause of your arthrosis.

Treating Arthrosis

Arthrosis treatment without surgery

One option for relieving the symptoms of arthrosis without surgery is orthotics. If the rolling movement of your foot is corrected by the sole of your shoe, this can significantly reduce your symptoms. Various manufacturers already offer shoes with rounded soles. Alternatively, an orthopaedic shoemaker can fit an orthotic insole into your everyday shoes which can assist to hold the ankle joint in the right position and stabilise the foot.

There are other potential treatment options that do not involve surgery, and our specialists will be able to advise on these. Lifestyle modifications, minimising high intensity activities, or switching to other physical activities which lower the strain on the joint - like swimming, which can be very helpful. Physical therapy to improve muscle strength surrounding the joint can alleviate the joint stress. Your consultant could also prescribe anti-inflammatory or pain medications, or assistive devices such as braces. At Schoen Clinic we will work with you to find the best solution.

Arthroscopy

If there are bone spurs on your X-rays, these can be removed using an endoscope (arthroscopy). During an arthroscopy, we insert a small camera into your joint via a small incision and the surgical instruments via a second incision. This enables us to remove even relatively large bone spurs in a tissue-conserving manner. Although, it is not possible to completely correct your arthrosis in this way, we achieve a significant reduction in pain and greater freedom of movement. This type of surgery can be helpful during the early stages of arthritis.

Ankle Arthrodesis (fusion) also known as Artificial anklyosis

This involves removing the destroyed cartilage from the joint and securely screwing your ankle bone onto the shin bone. Both bones will have merged together stably after 6-12 weeks, and you will be able to put weight on your foot again. By limiting the reinforcement to the destroyed joint parts, in most cases, a large amount of mobility can be preserved in your hind foot. For a lot of patients, this procedure can be carried out through arthroscopy, but it is also possible to carry out the procedure during open surgery. Today, fusion or artificial ankylosis is carried out in such a way that changing over to an artificial ankle joint would still be possible at some point in the future.

Artificial ankle joint (prosthesis)

It is also possible to replace the upper ankle joint with an artificial one in surgery to achieve mobility in your ankle joint. Between 85 and 90% of inserted replacements are still intact even after ten years. If however, loosening occurs the artificial ankle joint can be replaced in the future.

Ankle Arthrosis: Our specialists

Our foot and ankle specialists are at the forefront of their field. With a comprehensive and accurate diagnosis at Schoen Clinic London, we will get you back on your feet in the most effective way possible.

Dr Roger Wolman

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant - Rheumatology

Consultant - Sports & Exercise Medicine

Consultant Rheumatology and Sport & Exercise Medicine
MD (Res) FRCP FFSEM
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Mr Ali Abbasian

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Foot & Ankle

Consultant Orthopaedic Surgeon 
MBBS FRCS(Tr&Orth)
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Mr Kumar Kunasingam

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Foot & Ankle

Consultant Orthopaedic Surgeon
BSc(Hons) MBBS(Eng) MRCS(Eng) FRCS(Tr&Orth) DipSEM DipOrth
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Mr Stefan Weitzel

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Foot & Ankle

Consultant Orthopaedic Surgeon
MD FRCS(Eng) FRCS(Tr&Orth)
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Dr Philip Batty

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant - Sports & Exercise Medicine

Consultant Sport and Exercise Physician
MB ChB, MRCGP, FFSEM
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Prof Mike Loosemore MBE

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant - Sports & Exercise Medicine

Consultant in Sport and Exercise Medicine
MBBS MSc PhD FFSEM(UK)
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Dr Julian Widdowson

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant - Sports & Exercise Medicine

Consultant Sport Exercise Medicine Physician
MBBS MRCGP DCH DRCOG MScSEM FFSEM
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Ankle Arthrosis: Our specialised hospital

Our award-winning hospital is home to some of the finest experts in all aspects of foot and ankle conditions. From the very moment you begin your journey with us we treat you as a partner in your own care, doing all we can to provide the best possible outcome and the brightest possible future for you and your feet.

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Authors, 01.07.2020