Foot and Ankle Arthritis

Arthritis means pain within a joint. There is no cure but with early treatment its able to reduce the pain and disability.

TYPES AND CAUSES OF ARTHRITIS

Osteoarthritis

It is due to wear and tear of joints when the smooth gliding surface covering the end of bones {cartilage} becomes  irregular and destroyed.

• Occur in older people as the ability of the cartilage to heal itself decreases with age.
• Obesity and family history increase the risk of getting arthritis.

Rheumatoid Arthritis: It is an inflammatory disease where patients own body defence mechanism attacks and destroys the cartilage.

• It can affect other organs like eyes, skin, lungs etc .
• Infection or environmental factors makes certain people more susceptible to it.

Post Traumatic Arthritis:

It develops after an injury to the ankle and foot like a fracture, ligament (tough band of tissue which keeps the bones and joints in place) injury, dislocations or severe sprain.

SYMPTOMS

1. Pain or tenderness (pain on touching)
2. Stiffness or reduced motion and difficulty in walking
3. Swelling

DIAGNOSIS:

• Gait analysis is one of the  test performed during physical examination. It will show how the bones in the leg and foot line up with walking, tests the strength of the ankle and feet.
• XRay are most valuable test to diagnose the severity of arthritis it shows changes in the spacing between the bones or in the shape of the bones.
• Weight bearing XRays, Bone scan, CT scan or MRI may also be used in evaluation.

TREATMENT

It depends on the type, location and severity of arthritis.

Treatment can be of many types

NONSURGICAL TREATMENT

• Pain relievers and anti-inflammatory medications (steroids injected into the joints to reduce swelling).
• Physical therapy and exercise
• Shoe inserts (orthotics), such as pads or arch supports like stiff-soled shoe with a rocker bottom
• N ankle-foot orthosis (AFO)
• Weight reduction

SURGICAL TREATMENTS

It is indicated is arthritis is not responding to nonsurgical treatment.

The choice of surgery depends on type of arthritis, the impact of disease on the joint, location of the arthritis.

Surgeries performed for arthritis of the foot and ankle are

1.  Arthroscopic debridement

Cleaning the joint  after  directly inserting a pencil shaped flexible scope   inside the joints and identifying  the problem areas and removing  the area of foreign bony outgrowth (spurs) and    inflamed tissue.

2. Fusion of the joints (Arthrodesis)

Fuses the bones of a joint by using  pins,plates and screws or rods making it one continuous bone.

The complication with arthrodesis is development of arthritis of the joints adjacent to those fused due to increased stresses applied to the adjacent joint.

3. Replacement of the affected joints (Arthroplasty) damaged ankle joint is replaced with an artificial implant

Ankle replacement is advised in patients with Advanced arthritis of the ankle where the  joint surfaces is destroyed