Ankle arthritis is cartilage damage in the ankle joint causing pain, swelling and stiffness. Most cases follow an old fracture or instability rather than simple wear, so it often affects younger adults. Many are managed for years with injections, bracing and activity changes; surgery means fusion or replacement.
Symptoms
- Deep aching pain that is worse with weight-bearing
- Morning stiffness, usually under 30 minutes
- Swelling around the joint
- Reduced up-and-down ankle movement
- Grinding or catching
Causes & risk factors
- Previous fracture or instability (70–80% of cases)
- Rheumatoid or inflammatory arthritis
- Loss of blood supply to the talus
- Less often, primary osteoarthritis
Conservative treatment comes first
- Simple pain relief
- Rocker-sole footwear
- An ankle brace
- Low-impact exercise and physiotherapy
- Image-guided steroid or hyaluronic acid injections
When surgery is considered
Ankle fusion gives durable pain relief but loses ankle movement, and is often done by keyhole — weight-bearing at 10–12 weeks, full recovery 6–12 months. Total ankle replacement preserves movement and suits older, lower-demand patients but can wear out. The choice depends on age, activity, bone quality and deformity.
Questions & answers
Neither is universally better. Fusion is durable and reliable but stops ankle movement; replacement keeps movement but can wear out. We match the choice to your age and activity.
Most people walk comfortably; the foot's other joints take over much of the lost motion, though uneven ground feels different.
No. Low-impact activity is good for an arthritic ankle.
Sources & further reading
- BOFAS — ankle arthritis guide
- OrthoInfo (AAOS) — arthritis of foot and ankle
