Progressive arthritis can lead to bone cysts and the formation of bone spurs (osteophytes).
Ankle debridementand exostectomy are procedures used to “clean up” the joint to restorerange of motionand reduce pain.
Both are used to treat mild to moderate ankle arthritis and typically performed on an outpatient basis.
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Exostectomy refers specifically to the removal of motion-blocking osteophytes.
If the damage is extensive or difficult to access,open surgerymay be performed using a larger incision.
Although these procedures can provide significant relief, bone spurs can reform over time.
Secondary scar tissue can also develop and interfere with joint function.
In such cases, additional surgery may be required.
It is usually considered when there is minimal degeneration of the ankle joint or misalignment of the ankle bones.
Depending on the severity of the condition, surgery may either be arthroscopic or open.
The bones will then be permanently fixed with plates, nails, screws, or other hardware.
The downside of ankle fusion is that it significantly reduces ankle flexibility.
It typically is performed when there is a sizable, well-defined defect in the cartilage of the ankle.
The clots will gradually turn into a pop in of scar tissue called fibrocartilage.
The microfracture procedure can be performed arthroscopically on an outpatient basis.
People with more extensive cartilage damage may benefit from a newer product called BioCartilage.
The final surgical option is anosteochondral graft.
This is a invasive procedure and often requires breaking a portion of bone to enter the damaged area.
Osteochondral grafts are reserved for extremely large defects or when other cartilage repair efforts fail.
The procedure involves stretching out the ankle joint to increase the space between the talus and tibia bones.
The goal of ankle arthrodiastasis is to provide the damaged cartilage time and space to repair itself.
Still, it doesn’t destroy underlying tissues and may help preserve future treatment options.
Modern prosthetics are composed of porous metallic materials stabilized with or without cement.
Although prosthetic designs have improved in recent decades, ankle replacement remains challenging because of the joints multidirectional physiology.
Success rates tend to be lower than with knee and hip replacements.
There are pros and cons to ankle replacement.
On the one hand, it offers a better range of motion and higher satisfaction among recipients.
Recovery times are invariably longer and require moreextensive physical therapyand rehabilitation.
People with ankle replacements are advised against high-impact activities such as running and jumping.
Swimming, cycling, and hiking are generally acceptable.
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