Your feet and ankles provide support and balance every time you take a step. But for some people, it’s hard to put their best feet – and ankles – forward because of arthritis.
Ankle arthritis, in particular, occurs much less often than other joints, but it can be just as painful and physically limiting.
“Ankle arthritis is a degenerative disorder where the cartilage in the ankle joint wears out over time,” said L. Daniel Latt, MD, an orthopedic surgeon and foot and ankle specialist at Banner - University Medicine. “It is most often caused by ankle trauma, such as a fracture or sprain, and can cause pain, swelling and limit one’s range of motion.”
Progressive arthritis can lead to bone cysts and the formation of bumpy growths known as bone spurs (osteophytes).
The good news is that you don’t have to live with chronic pain. If conservative treatments, such as ankle braces, cortisone (steroid) injections and physical therapy aren’t helping, you may consider ankle exostectomy, also known as a cheilectomy.
Read on to learn about cheilectomy and other surgical options for treating ankle arthritis.
What is an ankle cheilectomy?
Cheilectomy is a surgical procedure where bone spurs that form in the front and on the sides of the ankle are removed to relieve pain and decrease impingement, meaning the bone spur becomes pinched when the ankle moves up and down.
The procedure essentially “cleans up” the joint to restore the range of motion and reduce pain.
“The bone spurs form because the thinned or missing cartilage creates excess pressure on the bone, which then forms additional bone,” Dr. Latt said. “Patients with mild to moderate arthritis with limited motion and pain, which is mostly at the end of the range of motion, are most likely to benefit from exostectomy.”
The bone spurs can be removed with either open (with an incision) or arthroscopic surgery (with a camera through a small keyhole incision).
“An ankle cheilectomy for small areas of spurs or tissue can usually be performed arthroscopically. However, for larger bone spurs, it may be more efficient and effective to make a larger incision, open up the ankle joint and remove the spurs,” Dr. Latt said.
What is recovery like with an ankle cheilectomy?
Your recovery after surgery may depend on the size of the bone spur and the degree of swelling that occurs during surgery. Generally, ankle cheilectomy offers a high satisfaction rate with a relatively simple recovery.
“After surgery, patients typically wear a boot for three weeks but can walk in the boot,” Dr. Latt said. “Bone spurs tend to grow back gradually over time, but this can take years, during which patients may experience significant relief of symptoms.
Physical therapy may also be prescribed after surgery to help work on a range of motion and ankle strength.
What are other surgical treatments offered for ankle arthritis?
In addition to ankle cheilectomy, ankle fusion and ankle replacement are other surgical options.
Also known as ankle arthrodesis or tibiotalar arthrodesis, ankle fusion is a surgery that removes the worn-out portion of the joint and secures together, or fuses, the two bones of your ankle into one piece.
“While this is successful at eliminating the pain, the restriction of motion can create other problems, such as arthritis in other nearby joints,” Dr. Latt said.
Ankle replacement is a newer treatment where the damaged ankle joint is replaced with a metal or plastic implant (bearing). This type of surgery is generally considered if you have severe arthritis in your ankle and no longer respond to steroid injections or other conservative treatments.
Can I prevent ankle arthritis?
While ankle arthritis might be inevitable with age, there are things you can do to help prevent ankle and foot arthritis. The first of which is managing your weight.
If your ankles and feet are supporting a lot of weight for a long time, the weight will start to wear down on your ankle cartilage faster.
Here are some other ways to care for your ankle and feet:
- Participate in low-impact exercises that stretch and work your muscles and joints, including your Achilles tendon or toes.
- Wear sturdy, supportive shoes that are shaped like your foot and have rubber soles to provide more cushioning.
- Avoid wearing flip-flops that don’t support your arch or ankle.
[Also read “7 Common Shoe Mistakes That Could Be Crushing Your Feet”]
Ankle arthritis is a condition where the ankle joint cartilage starts to wear down, causing pain and restricted movement. Over time, this can lead to bone cysts and bone spurs.
When conservative treatments like steroid injections no longer provide relief, surgical treatments like ankle cheilectomy, ankle fusion or ankle replacement may be considered if pain and loss of mobility hinder your quality of life.