Foot and ankle arthritis: a to-the-bone understanding

What is arthritis and how does it affect the feet and ankles? Leading foot and ankle orthopaedic surgeon, Mr Samer Morgan, shares his expertise. The surgeon who practises in Manchester, Liverpool, and Warrington explains the different types of arthritis, and how they are diagnosed and treated.

What is arthritis?

Cartilage is a tough but flexible tissue that has many functions in the body. As we get older, the cartilage, that cushions bones and joints, degrades and wears away, resulting in inflammation. This inflammation is arthritis and causes pain, swelling, stiffness, and difficulty moving.

How does arthritis in the foot and ankle occur?

Arthritis in the foot and ankle can occur because of a fracture, dislocation, overuse, or as a side effect of an autoimmune disease. The most commonly affected joints of the foot are the joint connecting the shin and ankle bone and the joint connecting the big toe to the foot. The heel bone and the inner and outer mid-foot bones are also often affected. Common symptoms are pain, tenderness, swelling, stiffness, and limited movement.

What types of arthritis affect the ankle and foot?

Three types of arthritis affect the ankle and foot, these are:

• Osteoarthritis is a degenerative joint disease. This is the most common arthritis, usually a result of aging. The cartilage that once protected the bones and joints from rubbing against each other is worn down, leaving little to nothing protecting from bone-to-bone contact in the joint. Bone spurs can also occur when the bone bulges out of the joint.

• Rheumatoid arthritis is an autoimmune disease. The immune system attacks the body’s joints, tissues, and organs, even though they are healthy. Usually, it is caused when the disease-causing genes are triggered by either infection or an environmental factor. The body starts to create antibodies that target joints. The symptoms normally begin in the feet and are symmetrical normally.

• Following an injury such as a fracture, sprain, or ligament tear, post-traumatic arthritis can occur. Cartilage cells can be damaged by hormones that the body produces when injured. The build-up of uric acid crystals, a bodily waste product, can also over a long period in the joints contribute to post-traumatic arthritis.

How is arthritis of the ankle and foot diagnosed?

If a person is experiencing the symptoms of arthritis, they should book a consultation with their doctor to get a correct diagnosis. Their doctor will assess their medical history and perform a physical examination. Imaging tests, such as X-rays, bone scans, CT scans, and MRIs, along with blood tests are performed to determine the cause of the symptoms.

How is arthritis of the ankle and foot treated?

Anti-inflammatory medication, steroid injections, physical therapy, and medical devices called orthotics that are inserted into the shoe to support the feet are non-surgical treatments that can help manage the symptoms of arthritis. If conservative treatment doesn’t help symptoms improve, surgery may be needed. There are three surgeries that can be performed for arthritis:

• Arthroscopic surgery, is a procedure used to examine the joint internally. An incision is made on the skin to pass an arthroscope (lens and lighting system) through to examine the joint. With the help of an arthroscope, the site can be treated by cleaning out foreign or inflamed tissue and removing bone spurs.
• Arthroplasty (Joint replacement) is the removal of a severely damaged joint and an artificial implant replaces it.
• Arthrodesis (fusion) is the fusing of two bones by removing the remaining cartilage, cutting the ends of the bone off, and fixing the two bones together. It can be done either on the foot or ankle. Motion is lost at the joint, but the pain is totally relieved.

If you are interested in finding out more about surgical options to help with symptoms of arthritis, you can book a consultation with Mr Samer Morgan by visiting his Top Doctor's profile today.