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Foot and Ankle Arthritis

The foot is a complex body part comprised of 26 bones that form over 30 joints to stabilize your foot and facilitate walking. A smooth covering of cartilage protects the bone surfaces and provides cushion as the joint moves freely. Arthritis is a condition characterized by cartilage deterioration and joint inflammation that leads to decreased joint spacing.

Three types of arthritis can affect the foot and ankle:

Osteoarthritis: The most common form of arthritis. This condition includes progressive wear and tear of the cartilage that typically affects middle-age and elderly people.

Rheumatoid Arthritis: A chronic, inflammatory disease that causes swelling of the joint lining and damage to the cartilage. This condition occurs more frequently in middle-aged women. Systemic symptoms such as fever, loss of energy and appetite changes can occur. Patients with this condition often have flare ups where more than one joint becomes painful and stiff. Other inflammatory conditions (gout, psoriatic arthritis, and lupus) can cause arthritis as well.

Traumatic Arthritis: Can develop after an injury to the foot or ankle, such as a fracture, dislocation, or severe ligament injury. Over time, the cartilage may wear away similar to osteoarthritis.

Symptoms include:

  • Progressive “aching” pain
  • Swelling
  • Stiffness
  • Difficulty walking

In patients with arthritis, x-ray imaging can show bones spurs, joint deformity, and a decreasing joint space indicative of cartilage loss.

Treatment Options

There are multiple treatment options for foot and ankle arthritis. You and your doctor can formulate a plan based on disease severity, location, and type of arthritis.

Activity Modification: For early stages for arthritis, activity modification such as swimming and biking instead of running can reduce stress on the joint. Losing weight if overweight can be of benefit as it will decrease the pressure across your joints while weight-bearing. Using assistive devices such as a cane and wearing orthotics or supportive shoes can decrease pain and provide support.

Medications: Anti-inflammatory medications reduce swelling and pain associated with arthritis. Glucosamine and chondroitin sulfate are natural substances found in and around cartilage. Oral supplementation of this is available over-the-counter and may help increase joint mobility.

Injections: Cortisone is a potent anti-inflammatory and can decrease pain and swelling when injected directly into a joint.

If arthritis does not respond to the conservative treatment, surgery may be an option. The type of surgery depends on the location and severity of disease. A joint fusion is a surgery where the damaged cartilage is removed. Pins, screws or plates are used to hold the bones together, fusing them into one. This is a successful procedure to relieve pain; however, motion is limited in the fused joint. Depending on the location of the arthritis, a joint replacement surgery may be performed. During a joint replacement, the damaged cartilage and bone is removed and replaced with an artificial implant. While developing an arthritis treatment plan with your physician, it is important to discuss risks and expected outcomes with the available treatment options.

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