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Ankle osteoarthritis
Background
Overview
Definition
Ankle OA is a degenerative joint disease that primarily affects the tibiotalar joint, leading to pain and disability.
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Pathophysiology
The pathophysiology of ankle OA involves the degeneration of articular cartilage. This degeneration leads to bone-on-bone contact, causing pain and stiffness. Additionally, changes in the subchondral bone have been implicated in the progression of OA. The disease also involves the synovium and joint capsules, leading to inflammation and further joint damage.
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Epidemiology
The prevalence of ankle OA is estimated at 30 per 100,000 person-years.
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Risk factors
Risk factors for the development of ankle OA include advancing age, obesity, previous ankle injuries (sprains or fractures), chronic ankle instability, joint incongruence, joint malalignment, and systemic conditions such as T2DM.
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Disease course
Clinically, patients with ankle OA typically present with pain, stiffness, and swelling in the affected joint. These symptoms often lead to functional limitations, such as difficulty walking or performing other weight-bearing activities.
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Prognosis and risk of recurrence
The prognosis of ankle OA is generally progressive, leading to chronic pain and functional impairment. While interventions such as intra-articular corticosteroid injections and a multimodal approach for pharmacological management can provide short-term benefits, advanced cases may require surgical interventions such as total ankle replacement.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of ankle osteoarthritis are prepared by our editorial team based on guidelines from the American College of Foot and Ankle Surgeons (ACFAS 2020), the American College of Radiology (ACR 2020), the American Academy of Family Physicians (AAFP 2018), the European League Against Rheumatism (EULAR 2018,2017), and the National Institute for Health ...
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