1. Non operative treatment
Pain killers can be used including anti inflammatories. Splintage and a walking stick can also be used but all of these treatments are only effective in early disease and may not give complete pain relief.
Local anaesthetic and steroid can be injected into the joint in early disease but the injection usually does not give long term relief.
3. Ankle arthroscopy
This is keyhole surgery and a camera is placed into the joint together with small instruments and can be used in mild arthritis to tidy up any cartilage flaps that can irritate the joint and contribute to the symptoms.
4. Ankle fusion (arthrodesis)
This is the gold standard surgical treatment for ankle arthritis that is very effective at abolishing pain from the ankle arthritis. The joint is surgically fused usually with two screws and as a result no movement will occur at the joint.
There are two ways to achieve a fusion. It can be done as an open procedure but more and more fusions are now being done using arthroscopic techniques. The advantage of an arthroscopic ankle fusion is that the complications are less and in particular the risk of non-union is less.
Following an ankle fusion patients are placed into a below knee plaster for six weeks and will be non-weight bearing. A walker boot is then used for a further six weeks during which time some weight bearing is allowed.
5. Total ankle replacement
Ankle replacement like fusion aims to abolish the pain from the ankle arthritis but it has the advantage of maintaining movement in the joint. This results in a more normal walking pattern. There are contraindications to ankle replacements and for some people fusion will be the only option.