A surprisingly common and simple injury can cause ankle arthritis
Ankle arthritis is less common that Hip and Knee arthritis. In fact, while Hip and Knee arthritis is commonly attributed to genetics and ‘wear and tear’ with increasing age, the ethology of ankle arthritis is often quite different.
The most common cause for someone developing ankle arthritis is due to a prior injury. This injury may have been a prior fracture (break) or simply a large ankle sprain / repetitive ankle sprains. Ankle sprains are one of the most common reasons for patients to present to their local GP following an injury. Thankfully, the majority of patients will recover well following a ‘simple’ injury. Unfortunately a portion of patients (10-20%) will go onto have recurrent ankle instability (Repetitive ankle sprains). The reason that this happens, is due to the deficient supporting structures on the outside of the ankle (‘Lateral ligament complex’). Over time it is not uncommon for patients to feel that there ankles are ‘weak’ and ‘giving way’ even when doing simple tasks like walking on uneven ground.
Every time that you ‘sprain’ your ankle, you run the risk of causing irreversible damage to the lining of the ankle joint (cartilage) and subsequently setting off a pathway that may lead to ankle arthritis down the track.
Once significant ankle arthritis has developed, management options are somewhat limited. Unlike hip and knee replacements, which have a very good track record, ankle replacements are still a ‘work in progress’, and not the panacea of long term pain relief that we regularly see with hip and knee replacements.
Patients of mine that develop recurrent ankle sprains are all strongly encouraged to rehabilitate appropriately to reduce the risk of falling into the category of developing ankle arthritis. Depending on the patient demographic and individual factors, a ‘lateral ligament repair/reconstruction’ if often warranted. This involves reattaching the ruptured ligaments on the outside of the ankle to prevent ‘instability’. This procedure has a high success rate, and combined with a tailored rehabilitation plan, is designed to ‘strengthen up’ the ankle and prevent it from continuing to ‘roll’.