Feeling Ill? Don’t Self Diagnose

Posted on: 15 May 2015

Arthritis is a general term for a range of diseases and conditions that are the result of inflammation of the joints. There are several types of arthritis that can affect the foot and ankle, including posttraumatic arthritis, which typically develops after an injury to the foot or ankle, such as a fracture or dislocation.

Cause of Post-traumatic Arthritis

Post-traumatic foot and ankle arthritis is often the result of injuries to the foot and/or ankle. An injury can damage the cartilage and/or bone, which changes the mechanics of the joint, causing the cartilage between joints to wear out quicker. Post-traumatic foot and ankle arthritis can develop several years after the initial injury, even if the injury was appropriately treated. Each of your feet have 26 bones and over 33 joints and the most common joints in the foot affected by arthritis include:

• The joint of the foot and big toe bone.
• Three of the foot joints that involve the bones of the heel, the inner mid-foot and the outer mid-foot.
• The joint where the shinbone and the ankle meet.

Symptoms of Post-traumatic Arthritis

The symptoms of post-traumatic foot and/or ankle arthritis vary in degree, depending on the severity of degeneration. Some people with post-traumatic arthritis may develop bone spurs on the ankle joint, which can significantly limit your movement of the ankle joint. In some situations, calluses or blisters develop over the surface of the bone spur, which will cause additional pain. Other symptoms of post-traumatic foot and ankle arthritis may include:

• Joint pain, tenderness and/or swelling
• Joint stiffness and instability
• Reduced range of motion
• Difficulty walking or participating in activities that stress the joint

Nonsurgical Treatment

The initial treatments for post-traumatic arthritis of the foot and ankle are typically nonsurgical. Your podiatrist may recommend one or more of the following options:

• Change in lifestyle-lifestyle changes may include minimizing activities that aggravate the symptoms, losing weight to reduce the stress on your joints and low impact activities, such as swimming.
• Physical therapy-your foot doctor may recommend specific exercises that will help increase flexibility and range of motion. However, your doctor may stop this type of treatment, if the physical therapy aggravates the joint pain.
• Assistive devices-wearing a brace (ankle-foot orthosis) or using a cane may help with mobility. Wearing shoe inserts or shoes that have been custom made with rocker bottoms or stiff soles may help reduce the pressure on your foot and decrease the pain.
• Medications-non-steroidal anti-inflammatory drugs, such as naproxen and ibuprofen may help to relieve the pain and reduce swelling. In some situations, your podiatrist may recommend cortisone injections to temporarily relieve the inflammation.

Surgical Treatment

Foot surgery for post-traumatic foot and ankle arthritis is not typically recommended, unless the arthritis has substantially progressed and/or non-surgical treatments were not effective. Some of the most common types of arthritis-related foot surgeries include:

• Fracture repair, which may be necessary if the bone was displaced during an injury. This surgery involves repositioning the bone and installing hardware to hold it in place during healing.
• Arthroscopic debridement, which is often typically only done during the early stages of arthritis. The procedure is often helpful for removing bone spurs or inflamed tissue that has formed on the joint.
• Joint fusion, also known as arthrodesis, involves removing the ends of the bones where the joints are formed and joining the ends with screws or pins until they fuse together. This procedure helps to reduce pain by eliminating joint movement.
• Ankle replacement, also known as arthroplasty, is used to remove the damaged cartilage and bone and replace them with metal or plastic surfaces to help to restore the joint function. Ankle replacement is typically only done if the arthritis has caused extreme damage to the joint or if your pain interferes with daily activities.

Your feet and ankles provide support during walking, standing and running. They are responsible for shock absorption, balance and motion, so if you experience any pain or discomfort in your feet and/or ankles, it is essential that you visit your foot doctor as soon as possible. Your doctor will look for a variety of things to help determine if you have post-traumatic arthritis as well as the extent of the arthritis.