Featuring Dr. Alastair Younger, MB, Ch.B, M.Sc, Ch.M, F.R.C.S.(C), Orthopaedic Foot and Ankle Surgeon

What Are Your Surgery Options for Ankle Arthritis

Duration: 3 minutes, 7 seconds

Arthritis can affect a number of joints in the foot. 

And while ankle arthritis, which is the most well known, is less common than hip and knee arthritis, it is one joint of many joints in the foot that can become arthritic in time. So the joints that are involved in arthritis in the foot are numerous and they can be arthritic either on their own in isolation, or they may be arthritic in combination with other joints or deformity.

Exciting things are happening in the treatment of end-stage ankle arthritis and the developments include the development in the last few years of better ankle joint placements that can resurface these two surfaces of the ankle joint, like hip or knee joint replacement. 

If a joint replacement’s not appropriate for you in discussion with your surgeon then the other way of dealing with this joint is to take out the lining of the remainder of the cartilage in the joints of these two bones conjoined together, known as a fusion, but it can be now done arthroscopically - or through the scope - with two small incisions on each side. 

That means you have much less swelling and better results and function at one or two years after the operation compared with having it done with an open operation. So that’s ankle arthritis – lots of good news there. 

The other joints in the back of the foot can't be replaced. They can only be fused, or the remainder of the cartilage that’s damaged taken out and each bone held in a correct position. And the bone is encouraged to join together by keeping you off your feet after the operation and also making sure that the joint is held in one position so that it does heal and it heals straight. 

And these operations now have a success rate of up to 95 percent or more in which the bones successfully join together using newer treatment techniques such as better screws and substances that can stimulate the bones to grow together. 

So arthritis can affect joints also in the front of the foot. It’s very important when arthritis surgery is done that the foot is restored to its normal shape and that the bones heal together, because if the bones don’t heal together then you’ll end up with ongoing pain and deformity and you’ll need a repeat or a revision operation. 

The operations – if this does not happen – are very successful and are very good at resolving foot and ankle pain and discomfort. So if you have arthritis in your foot and it’s not getting better in time, and you’ve tried all sorts of other things to make it better, such as modifying your shoes and getting inserts or wearing braces, then you might need to talk to your doctor and ask them if a foot operation may help you, and then you can be referred onto an orthopedic surgeon who can do some of these operations.

Presenter: Dr. Alastair Younger, Orthopaedic Surgeon, Vancouver, BC

Local Practitioners: Orthopaedic Surgeon