Bilateral flatfoot before Surgery and  Bilateral flatfoot after Surgery
Ankle Arthroscopy and Subtalar Arthroscopy
Ankle Arthritis in Rhuematoid patient and Ankle Replacement in Rhuematoid Arthritis
Diabetic foot before Surgery and Diabetic foot after Surgery
Claw toe deformity in Rhuematoid patient and Claw toe deformity in Rhuematoid patient after surgery
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Ankle Arthritis in India


What is ankle arthritis or Arthritis of the Ankle?
 
Ankle arthritis is wear and tear or degeneration of ankle joint. Normally in body the ends of the bones where they form joint are covered with a thick smooth layer of cartilage. Cartilage lowers friction allowing smooth movements like ball bearings in a fan. In arthritis cartilage is destroyed leading to rough bone rubbing on bone. This is seen on xray as reduction in Joint space(picture 1 & 2).
 
What symptoms do I feel if I have arthritis in the ankle?
 
Arthritis causes inflammation inside joint. Symtoms of arthritis are pain in the ankle, stiffness and ankle swelling arising from the ankle joint. Sometimes especially if arthritis develops after an injury there can be associated deformity of ankle.
 
What causes arthritis in ankle?
 
In ankle joint unlike hip and knee joint primary osteoarthritis is rare. The commonest cause is post-traumatic or arthritis developing secondary to ankle fracture. Other causes of arthritis include inflammatory arthropathies such as rheumatoid arthritis and psoriasis and also haemophilia. Patients usually present with pain and stiffness and sometimes instability.
 
Treatment of Ankle Arthritis
 
Treatment initially consists of anti-inflammatories, modification of activity and bracing.
If these fail there are a number of surgical options.They depend upon the severity of Arthritis.
Include
  • 1. Arthroscopic debridement of Ankle

    A debridement for ankle arthritis is useful in the earlier stages of the arthritic process. Ankle Arthroscopy is normally performed as a day case procedure and generally patients can weight bear straight away on the operated ankle. The success rate for the procedure is round about 80%. One needs to understand that arthroscopic debridement is not a permanent fix for arthritis.Success rate of corresponds to the percentage chance of improvement but not complete symptom resolution. ( Picture & link)

     
  • 2. Corrective Osteotomy with or without ligament reconstruction

    Osteotomy has a role in a young patient with early localised disease associated with mal-alignment of bones either tibia or talus. Supramalleolar opening or closing wedge osteotomy is done for supramalleolar tibial
 
Corrective Osteotomy for Ankle Arthritis
     
 

Deformity Picture

     

Calcaneal ostetomy and ligament reconstruction is considered in early ankle arthritis secondary to chronic lateral ligament insuffiency and varus deformity of ankle(picture).

Early arthritis associated with Malunion of fracture is also treated with an appropriate reconstruction(picture).

  • 3. Joint distraction with an External Fixator

    Early osteoarthritis in a young patient can also be treated with Arthroscopic debridement and joint

     
 
Joint distraction for early Ankle Arthritis
     
 

Distraction Picture

     

Fusion is joining together of two adjoining joint surfaces with help of metal work. In arthroscopic or minimally invasive ankle fusion surgery the ankle joint surfaces are prepared through two small 1 cm incisions called portals using special key-hole camera and hair-pin size miniature instruments. The whole process is co-ordinated with the help of TV screen on which camera telecasts the video from inside the joint.

  • 4. Arthroscopic Ankle Fusion

Open ankle fusion is the traditional time tested method for Ankle and subtalar joint arthritis

  • 5. Open Ankle Fusion