Osteoarthritis of the Foot and Ankle

What is Osteoarthritis? Osteoarthritis is the wear and loss of cartilage in a joint. Cartilage is the protective smooth layer at the end of bones that allows smooth pain free motion at that joint. Once our cartilage begins to “wear out”, movement and activities become painful. There are many types of arthritis; however, the degenerative type we are discussing is the most common as it occurs naturally with age. Osteoarthritis affects millions of Americans and can affect any joint. In the foot, arthritis most naturally affects the big toe joint but also affects the midfoot and ankle joints.

Causes of Osteoarthritis? Osteoarthritis is a disease of wear and tear on your joints over a period of time. As the cartilage loss continues, the bones begin to rub together creating pain and inflammation within the joint space. Trauma or injury may also cause early onset osteoarthritis, although it may take months to years for the arthritis to develop. In the ankle, osteoarthritis can be caused by a fracture or severe ankle sprain. The great toe joint arthritis may develop after a kicking or jamming injury of the toe. Midfoot arthritis is often caused by a fracture or severe flatfoot deformity. Abnormal foot biomechanics may also result in degenerative arthritis such as flatfoot and high arch deformities.

Symptoms? Pain, stiffness, swelling, difficulty moving a joint with often a bony prominence or bone spur at the area of bone on bone arthritis. Pressure from a shoe on the bony prominence may limit motion and aggravate pain.

Diagnosis? A physical exam with additional testing such as x-rays and CT scan will aid your surgeon in the most accurate diagnosis guiding them on proper treatment.

Treatment? Conservative treatment includes NSAIDS, joint supplements such as glucosamine, steroid injection, custom orthotics / bracing, physical therapy, and finally surgery. Surgery may include a joint replacement or fusion procedure. Your foot and ankle surgeon will discuss the options and make a treatment plan that is specific for your needs and expectations.

Kevin C. Bryant, DPM FACFAS

Diplomate, American Board of Foot and Ankle Surgery