Why Does Ankle Arthritis Develop After an Ankle Fracture?
Dr. Gary Driver is a podiatrist practicing in Fort Worth, TX. Dr. Driver is a fellowship-trained foot and ankle surgeon specializing in reconstructive surgery of the foot and ankle. During his fellowship, he underwent advanced training in ankle replacements, arthroscopy, foot and ankle trauma, sports medicine, and complex... more
When patients suffer an ankle fracture, the alignment of the ankle joint is often affected. If the ankle fracture is more minor, and the fracture is stable, then we can treat this with immobilization and avoid surgery. When the fracture is more severe and the ankle joint is unstable or not aligned correctly, we recommend surgical fixation to try to realign the ankle joint and decrease the risk of arthritis developing.
If the ankle joint is not correctly aligned and is even 1-2 mm off, the cartilage surfaces in the joint will wear more quickly over time and patients will develop ankle arthritis. This is primarily because the forces are going through the ankle joint in a more aggressive manner, which causes the cartilage to wear down and arthritis to develop.
If patients have had an ankle fracture surgically fixed but are having pain over the hardware or in the ankle joint, we typically recommend removing the hardware and performing ankle arthroscopy with synovectomy. This is to try to clean up arthritis in the joint as much as possible, to decrease pain.
This can certainly be helpful in the short run, but we do see patients who have suffered an ankle fracture previously that will eventually develop ankle arthritis. Ankle arthritis was previously treated with ankle fusions, but ankle replacements have become much more common because we can now perform most of these through CT guidance. This makes the ankle joint replacement/arthroplasty much more precise and lets them last longer and give better pain relief.
