Nonoperative management of ankle arthritis

ABSTRACT

Although hip and knee osteoarthritis are mostly of primary origin, ankle osteoarthritis is of posttraumatic origin. In sports injuries, the ankle is the second most commonly injured body site after the knee. In addition, compared to the cartilage in the knee joint, ankle cartilage has a higher content of proteoglycans and water, and an increased rate of proteoglycan turnover and synthesis, all of which are responsible for its increased incidence of posttraumatic origin osteoarthritis. Nonoperative management of ankle arthritis typically starts with weight reduction, activity modification, and oral non-steroidal anti-inflammatory drugs, physical therapy, and can progress to gait-aids including a cane, shoe-wear modification, patellar tendon weight-bearing ankle-foot orthosis, and intra-articular injections with corticosteroids or hyaluronic acid.