Drs. Lawrence and Szpara have trained extensively in total ankle replacements and are certified in 3 different systems:
Wright Medical Prophacy (InBone and Infinity)
Stryker STAR
Integra Cadence
Ankle Arthritis:
Arthritis is a general term for a group of more than 100 diseases. Arthritis simply means “joint inflammation.” When it affects the ankle joint, it can produce swelling and pain which may eventually result in deformity, loss of joint function and decreased ability to walk. The most common form of ankle arthritis is osteoarthritis.
Causes of Ankle Arthritis:
Ankle arthritis can occur from a number of factors. One of the most common causes of ankle arthritis is repetitive ankle sprains (rolling your ankle). Other factors that are less frequently occurring, but often lead to ankle arthritis are previous ankle fracture, previous ankle injury, repetitive impact which could occur from a high demand job or sports, or a tight Achilles tendon.
Symptoms of Ankle Arthritis:
Tenderness to the touch
Pain on or decrease of ankle movement/motion.
Pain when walking.
Increased warmth, stiffness or swelling at the end of the day.
Increase pain in the morning.
Diagnosing:
A detailed history is taken from the patient. This history includes the duration of symptoms, history of sprains, prior trauma or surgery, the type of symptoms they are experiencing, and a physical exam. Initially, X-Rays are obtained to determine the integrity of the ankle joint and the amount of arthritis present. Further imaging such as a CAT scan or MRI may be needed to diagnose or plan for surgery.
Treatments:
The goal with every patient is to get them back on their feet pain free as soon as possible without the need of surgery. Simple methods of treatment may include bracing. Bracing limits the amount of motion at the ankle joint which reduces pain. Oral over the counter and prescription level anti-inflammatories have also yielded good results.
Most people end up requiring a steroid injection or a series of injections in order to alleviate the pain, especially during a flare up. If steroids don’t work, stem cell therapy may be an option for you.
Unfortunately, these conservative treatments do not provide significant relief for everyone. Of these patients, an ankle arthroscopy is a minimally invasive procedure that has low risk and high reward. Patients are able to walk immediately after an ankle arthroscopy procedure. It also gives the surgeon the ability to directly visualize the integrity of joint cartilage or see if the ankle is “bone on bone.” The surgeon can also take intra-operative pictures to share with the patient.
If the above mentioned treatments do not provide improvement, an ankle fusion may be necessary to treat the end stage arthritis. Ankle fusions were the gold standard for treating end stage ankle arthritis for years, but aren’t ideal because it locks up all motion at the ankle joint. Luckily, todays total ankle implants have evolved into an appropriate motion saving treatment for patients with end stage ankle arthritis.