Q: X-rays of my right ankle show arthritis on just one side of the joint. I’d love to continue training for marathons, but the pain is becoming unbearable. I’m not keen on fusing the joint. Is there another solution?
A: Osteoarthritis caused by a misaligned ankle is quite common, with trauma often being the initial cause in 70 to 80 percent of cases. When conservative treatments fail, surgery is typically recommended. The two primary surgical options are ankle joint fusion or total ankle replacement (TAR). However, for some patients, a joint realignment surgery may be a viable alternative.
In this procedure, the surgeon aims to balance the uneven joint space by adjusting the alignment of the bones. This can involve reducing tension on the tendons, altering the angles between the bones, and lengthening or shortening the bone as needed.
By redistributing the forces across the joint more evenly, this surgery can correct deformities in the midfoot, forefoot, or hindfoot. If realignment surgery does not achieve the desired results, fusion or TAR can still be performed afterward.
This realignment approach has allowed some patients to continue participating in sports, including long-distance running and marathons, after the surgery.
Reference: Geert I. Pagenstert, MD, et al. Realignment Surgery as an Alternative Treatment for Varus and Valgus Ankle Osteoarthritis. In Clinical Orthopaedics and Related Research, September 2007, Vol. 462, Pp. 156-168.