Degenerative Ankle Disease
Ankle osteoarthritis is the breakdown of cartilage, causing chronic pain that can sometimes be severely disabling. It most often results from traumatic injuries, such as ankle fractures, calcaneal (heel bone) fractures, or recurrent ankle sprains.
This osteoarthritis can be well tolerated for a long time with straightforward medical management, sometimes supplemented by injections.
However, in the longer term, the only genuinely effective treatment is arthrodesis, meaning fusion of the painful joint. It is usually highly effective in relieving pain, but reduces ankle mobility and increases mechanical stress on the joints above and below it.
Ankle Arthrodesis
The arthrodesis most often performed is fusion of the subtalar joint, following the consequences of a calcaneal fracture.
Walking remains largely normal on level ground, but becomes more difficult on uneven terrain. The resulting ankle stiffness is limited, especially because the affected joint is often already very stiff.
In practical terms, the patient is immobilised for two months in a non-weight-bearing boot.
In osteoarthritis of the tibiotalar joint—most often following an ankle fracture or instability—the ankle must then be completely fused, particularly when both joints are affected.