Ankle Arthritis and Replacement

Joints are the places where bones come together. In a joint, the end of each bone is covered by a flexible tissue called cartilage. Each joint is surrounded by a capsule and filled with fluid. Your ankle joint is formed by three bones. These are your two lower leg bones, which are called the tibia and fibula, and the large bone in your foot, which is called the talus. Your talus sits on top of your heel bone, which is called the calcaneus.

Bands of tissue called ligaments hold the bones together. Pads of cartilage between the bones protect them. In some people, the cartilage that protects the ends of the bones wears away or gets injured. Sometimes, extra bone can form around the joint as a result of this wearing down process. When these things happen, you have a common type of arthritis called osteoarthritis.

Osteoarthritis can cause pain and swelling, and limit the motion of your foot.

Another kind of arthritis develops when the body’s own cells attack the joint lining. This lining becomes inflamed, painful, and swollen.  This is called rheumatoid arthritis.

There are other types of arthritis, but osteoarthritis and rheumatoid arthritis are the ones most likely to harm your ankle.


Some of the symptoms you might get with ankle arthritis include:

  • Pain
  • Difficulty walking
  • Stiffness
  • Swelling
  • Redness
  • Ankle deformity, and
  • Clicking or grinding when you move your ankle

Your symptoms may develop slowly but become severe over time.


Your health care provider will do an exam and may order several tests to figure out whether you have arthritis, and what type is causing problems in your ankle.

Your provider may recommend X-rays to see if cartilage has worn away or new bone has formed. You may also have blood tests.


Treatment for ankle arthritis typically starts with rest, ice, and medications for pain. Flexibility and strengthening exercises may also help. You may be sent to a physical therapist. Special shoes and shoe inserts are often recommended. Some people benefit from ankle braces. A cane might be helpful if you’re having difficulty walking.

If you continue to have symptoms, an injection of steroids or painkillers into your ankle might help.

If you have rheumatoid arthritis, you may get a prescription for medications to slow the arthritis.

If your symptoms don’t get better with treatment, your provider may recommend surgery. Surgery may also be helpful if you have deformities or disabilities from your arthritis. One type of surgery is arthroscopy. During this surgery, the doctor uses a small camera and instruments to clean up and smooth out your joint tissues. Another surgery is ankle fusion. During this surgery, the doctor uses bone screws, plates, or pins to fasten your tibia, and sometimes your fibula, to your talus. Once the joint is fused, you won’t be able to bend it very much, if at all.

In ankle replacement surgery, the surgeon removes parts of your tibia and talus. They are then replaced with an artificial joint made of metal and plastic. Ankle replacement often makes it easier to move your ankle.

If you’re thinking about ankle replacement surgery, it is important to know that the replacement joint will last for only a limited time.

Surgery is not a quick fix. Talk with your health care provider about all of your options. After any surgery, your own efforts with physical therapy will make a big difference in how well your ankle improves.

What We Have Learned

  1. There are three bones in the ankle joint. True or False?
    The answer is True. There are three bones in the ankle joint: the tibia, the fibula, and the talus.

  2. The ankle can be damaged by more than one type of arthritis. True or False?
    The answeris True. The most common types of arthritis that can damage the ankle joint are osteoarthritis and rheumatoid arthritis.

  3. Surgery can instantly fix pain and other problems in the ankle joint. True or False?
    The answer is False. Surgery is not a quick fix. Your own efforts with physical therapy will affect how well your ankle will improve.