Foot and ankle arthritis refers to the inflammation of the joints within the foot and the ankle. When these joints become inflamed, it can cause both swelling and pain that can lead to deformity, bone spurs, stiffness and loss of motion. The most commonly occurring type of arthritis found in the foot and ankle is osteoarthritis, which results from the breakdown of cartilage in the joints. Once the protective cushion of cartilage breaks down, the bones begin to rub together, causing the joints to become inflamed.
If you experience pain or stiffness in the joint, swelling on or around the joint, or difficulty walking or bending the joint, then you may be affected by foot and ankle arthritis. In some cases, a bone spur, or small bony protrusion, can develop on the joint and can cause blisters or calluses to form on the skin’s surface. To receive a diagnosis for foot and ankle treatment, schedule a consultation with Dr. Yurkanin today!
To diagnose foot and ankle arthritis, Dr. Yurkanin will perform a physical examination. During this examination, she will check for any signs of swelling, deformity, or bone spurs, as well as test the mobility of the joint. She will also take x-rays to determine the severity.
In most cases, foot and ankle arthritis can be treated non-surgically through the combined use of nonsteroidal anti-inflammatory drugs or steroid injections to reduce inflammation, orthotics and/or bracing to provide additional support, immobilization to resolve inflammation, and physical therapy to strengthen the muscles.
In some severe cases or in cases that do not respond well to non-surgical treatment, surgery may be needed to reduce pain and improve joint function. If surgery is needed, Dr. Yurkanin will develop a surgical plan based on your individual case. Some surgical treatments can include:
Total ankle arthroplasty, or ankle replacement, is a surgical procedure used to replace arthritic ankles with an implant or prosthesis, effectively relieving pain and restoring function. Ankle replacements are best suited for individuals with severe ankle arthritis, and are approximately 60 years of age. It is not recommended for individuals who are obese, or those who are affected by peripheral neuropathy, peripheral arterial disease, or severe osteoporosis.
Ankle replacement surgery generally lasts about two hours. During this time, Dr. Yurkanin will make an incision in the front of the ankle, remove the arthritic bones and cartilage, and insert an implant consisting of two metal pieces separated by a plastic spacer. Immediately after surgery, and for a few weeks following, you will have to avoid bearing weight on the ankle and will need to use a walker, crutches or some other walking aid. Recovery for this procedure takes approximately 8-10 weeks.
Fusion two bones of the ankle (namely the Talus and Tibia). This is usually done by preparing the joint and removing all cartilage from the joints and fixing with either metal screws or plates.
Triple arthrodesis fuses three of the foot joints (namely the talonavicular, subtalar, and calcaneocuboid) to decrease pain and increase function. To achieve this, the three joints are shaped and prepared for fusion. Once they are properly shaped, the bones making up the joints are properly aligned and fused together using metal hardware. These fusions eliminate the joint and the pain associated with it.
Subtalar joint fusion, only the subtalar joint (namely the calcaneus and talus). Fusion of the subtalar joint alleviates the constant pain caused by the bones rubbing against each other. Instead, they will move as one single piece, restoring function without the excess pain. To complete a subtalar joint fusion, an incision is made on the outer side of the foot, just below the ankle. Then, the bones of the joint are shaped, aligned, and joined together with metal hardware.
Midfoot fusion fuses the multiple midfoot bones that make up the arch into one single mass of bone. This approach can only fuse one midfoot joint, a few midfoot joints, or all the midfoot joints. By fusing the midfoot joints, arthritic pain is reduced, and function can be restored. To accomplish this, one or two incisions are made on the top of foot. Then the joints are shaped, aligned, and fused together using metal hardware, most commonly plates and screws. Depending on the nature of the procedure, a bone graft may also be required to fill gaps in the cartilage.
Osteoarthritis in the big toe joint, called metatarsal-phalangeal joint osteoarthritis or MTP joint OA, causes the joint to become excessively stiff, swollen, and it may or may not cause pain. To diagnose MTP arthritis, Dr. Yurkanin will perform a physical examination and test your range of motion. She may also take x-rays to confirm the diagnosis. MTP arthritis is treated non-surgically through footwear changes, the use of orthotics, regular exercises to maintain flexibility, and pain management through oral or injected medications. If surgical treatment is required, it can involve the use of the following surgical techniques:
Hemi implants are cobalt-chrome, slightly concave inserts that are smoothly polished on the joint side and contain a notched tube on the bone side for application with minimal bone tissue loss. To place the implant, Dr. Yurkanin will make an incision on the top of the foot alongside the big toe joint. Then, she will size it for the implant. Once the proper size for the implant is determined, the implant will be drilled into the joint’s surface.
By fusing the two bones that make up the MTP joint, this eliminates the painful joint motion. To fuse the MTP joint, an incision is first made on the top of the big toe. Then, the two bones that make up the joint are shaped and prepared for fusion. Once shaped, these two bones are properly aligned and a metal plate is placed over the two bones and screwed into place.
The MTP joint is completely removed from the toe and replaced with a joint implant made of metal or plastic. The type of implant will be determined by Dr. Yurkanin depending on your individual case.
Osteochondral fractures, also called lesions, refer to fractures that occur within the ankle joint and affect both the bone and the attached cartilage. When osteochondral fractures occur, the affected cartilage can blister, form cyst-like lesions, or fracture itself. Symptoms of osteochondral fractures include pain, swelling, catching or locking up of the ankle, and ankle instability. Often misdiagnosed as an ankle sprain, if rest and elevation are not alleviating the pain, then this could indicate an osteochondral fracture.
Dr. Yurkanin diagnoses osteochondral fractures by asking about your medical history and performing a physical examination of your ankle. X-rays will also be taken, but an MRI or CT scan may be needed to confirm the diagnosis. Depending upon the severity of the fracture, non-surgical and surgical treatments may be used.
Non-surgical treatments for osteochondral fractures include: immobilization and decreased weight bearing to allow the fractured bone and cartilage to heal, followed by physical therapy. Surgical treatments aim to repair any structural damage to restore the joint, minimize symptoms, and decrease the possibility of developing arthritis in the future. If surgery is needed, osteochondral repair can be treated with the following techniques:
A specialized surgical procedure where multiple drill holes are created in the bone defect to increase circulation and assist in the bone remodeling and repair. This can help provide a new surface over them, which restores function and mobility while decreasing pain and swelling.
Used as an addition to microfracture techniques, BioCartilage is composed of the same elements as naturally-occurring cartilage and is placed over a bone defect to assist in bone healing, restore function and decrease pain.
Yurkanin Foot and Ankle Reconstructive Center practices excellence in treating all of your foot and ankle needs, from minimally invasive surgery to complicated reconstructions for foot and ankle problems. Take a step in the right direction and schedule your consultation today!
Osteoarthritis is also referred to as degenerative arthritis because it usually develops as a result of the aging process. This is the most common type of arthritis and millions of Americans are affected by osteoarthritis as they age.