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What Is Ankle Arthritis and What Causes It?

Cartilage is a perfectly smooth and resilient layer over all joints that allows pain-free motion. Ankle arthritis involves the loss of cartilage in the ankle joint. Over time, bone spurs, pain, and deformity may develop.

The ankle is the most commonly injured joint in the body and bears the most weight per square centimeter; 5-7 times our body weight during walking. It is composed of 3 articulations: the tibia, fibula, and talus. The cartilage is very thin in the ankle compared to the hip and knee. The ankle is highly congruent, meaning that the talus matches the shape of the end of the fibula and tibia very well. If a patient loses the congruency from instability (repeated ankle sprains) or a previous fracture, arthritis may develop.

Who Can Develop Ankle Arthritis?

  • People who have had ankle injuries including fractures and sprains
  • Family history of ankle arthritis
  • Rheumatoid and other types of arthritis
  • Sufferers of recurring ankle infections

Evaluation and Diagnosis

In evaluating and diagnosing your condition, your surgeon will ask you about any previous ankle injuries, including significant sprains and broken bones. The ankle will be examined to check for tender areas, signs of swelling, motion, and deformity. Weightbearing X-rays (radiographs) are obtained to show the alignment of the ankle and is commonly the only diagnostic test needed to confirm ankle arthritis. One cannot ignore the shape of the foot when treating end-stage ankle arthritis so weightbearing foot radiographs are commonly obtained. These images may also reveal arthritis in joints of the foot. A CT scan may be obtained to further define the arthritis and evaluate bone loss if present. An MRI is rarely needed in the work up of ankle arthritis.

For more information about the Ankle Replacement Program at Inova Fairfax Hospital, call our orthopedic nurse navigator at 703-776-2289.