Arthritis is the inflammation of joints because of degeneration of the smooth cartilage that lines the ends of bones in the joint. This degeneration of the cartilages leads to painful rubbing of the bones as well as swelling, and stiffness in the joints. This usually results in painful and restricted movements. Arthritis in the foot and ankle can occur due to fractures, dislocation, inflammatory disease, or congenital deformity. The foot joints most affected by arthritis are:
- The joint between the shinbone (tibia) and ankle bone (talus)
- The three joints of the foot that include the heel bone, the inner mid-foot bone, and the outer mid-foot bone.
- The joint of the great toe and foot bone
There are three types of arthritis that can affect the foot and ankle:
- Osteoarthritis: this is the most common type of arthritis and occurs most often in the elderly. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge or stick out at the end of a joint (bone spurs). Osteoarthritis can also be called degenerative joint disease,
- Post-traumatic arthritis: Arthritis that develops following an ankle or foot injury is called post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, severe sprain, or ligament tear.
- Rheumatoid arthritis: This is an auto-immune disease in which the body’s immune system attacks healthy joints, tissues, and organs. Rheumatoid arthritis usually affects the joints of the hands and feet and tends to l affect the same joints on both sides of the body. It can cause pain, stiffness, swelling, and loss of function in the joints.
Causes of Foot and Ankle Arthritis
Osteoarthritis occurs because of aging. Rheumatoid arthritis is often caused when the genes responsible for the disease are triggered by an infection or environmental factor. This triggers the body to produce antibodies, the defense mechanism of the body, against the joint. Fractures at joint surfaces and joint dislocations may predispose an individual to develop post-traumatic arthritis. The body secretes certain hormones following an injury which may cause death of the cartilage cells.
The symptoms of foot and ankle arthritis include:
- stiffness limited range of motion
The diagnosis of foot and ankle arthritis is made with a medical history, physical examination, and X-rays of the affected joint. (CT) bone scans, and MRI scans may also Be performed to diagnose arthritis.
Treatment Options for Foot and Ankle Arthritis
Non-surgical treatment options for foot and ankle arthritis include:
- Medications (anti-inflammatories)
- Injections (steroids)
- Physical therapy
- Ankle-foot orthosis (AFO)
- Weight loss
- Orthotics such as pads or arch supports
- Canes or braces to support the joints.
- Possible use of Regenerative cell therapy and PRP (platelet rich plasma)
Surgery may be required to treat foot and ankle arthritis if the symptoms do not improve with above treatments. These surgeries may include:
- Arthroscopic surgery: Arthroscopy is a surgical procedure during which an arthroscope – a narrow lighted fiber-optic tube with a camera attached – is inserted into the joint through a key-hole incision. The arthroscope provides the surgeon with a large real-time image of the injury on a monitor. The surgeon diagnoses and treats the problem with small surgical instruments passed through small incisions. Forceps, knives, and shavers may be used to clean the joint area of foreign tissue, inflamed tissue or bony outgrowths (spurs). Once the surgery is complete, the incisions are closed.
- Arthroplasty or joint replacement: The surgeon may remove the damaged joint and replace it with an artificial implant. Joint replacement is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis or post-traumatic arthritis. The goal of joint replacement is to restore normal joint function and relieve pain.