ANKLE ISSUES FAQ

Q: I’ve been diagnosed with end-stage arthritis in my left ankle, and it’s really impacting my ability to walk. Even getting around my own home can be challenging on some days. I try to stay positive, but it’s tough not to feel down about how much it’s affecting my life. Do others feel this way too, or am I just being overly sensitive?

A: End-stage arthritis in the ankle is indeed less common than arthritis in the hip or knee, but it can be just as debilitating. Researchers at the VA Medical Center in Seattle, along with experts in Mechanical Engineering and Orthopaedics and Sports Medicine from the University of Washington, have studied this condition and its effects.

In a recent study, they examined 37 patients—both men and women—who were scheduled for surgery due to severe, end-stage ankle arthritis. These patients had tried non-surgical treatments to control pain and improve function but found no relief. As a result, surgery was planned, either to fuse the ankle or replace it.

The study aimed to assess how end-stage ankle arthritis impacts function. The researchers used various methods to measure this, including tracking the number of steps taken daily, step length, walking speed, and ankle motion. These measurements were then compared to those of healthy adults of similar age and gender who didn’t have ankle issues.

The main question was whether and how end-stage ankle arthritis affects daily function. They also wanted to identify at what point surgery becomes the best option and whether fusion or replacement surgery would be more effective.

While not all of these questions were fully answered, the study provided valuable insights into how to measure the impact of end-stage ankle arthritis on function and quality of life. The researchers found that everyone in the study had reduced ankle motion and strength compared to their unaffected side. Walking speed, the number of steps taken each day, and step length were all lower than in healthy adults. These factors were directly linked to physical function. Just moving around a room took more energy, more steps, and more time for those with end-stage ankle arthritis compared to healthy individuals. Patients who maintained better physical function also reported less pain and had a more positive mental outlook.

You might recognize some of these findings in your own experience—reduced function, increased pain, and decreased mobility can significantly diminish quality of life and take a toll on both mental and physical health. However, there are still potential avenues for improvement.

If you haven’t tried physiotherapy, it’s often recommended as the first step in managing this condition. Giving physiotherapy a solid three to six months before considering surgery is usually advisable. If conservative treatment doesn’t help, surgery could be an option. Your surgeon can evaluate your situation and guide you through your treatment options.

Reference: Ava D. Segal, MS, et al. Functional Limitations Associated with End-Stage Ankle Arthritis. In The Journal of Bone and Joint Surgery. May 2, 2012. Vol. 94. No. 9. Pp. 777-783.