Table of contents
Ankle osteoarthritis
What's new
Added 2020 ACFAS, 2020 ACR, 2018 AAFP, and 2018 EULAR guidelines for the diagnosis and management of ankle osteoarthritis.
Background
Overview
Definition
AO is a degenerative joint disease that primarily affects the tibiotalar joint, leading to pain and disability.
1
Pathophysiology
The pathophysiology of AO 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.
1
Epidemiology
The prevalence of AO is estimated at 30 per 100,000 person-years.
2
Disease course
Clinically, patients with AO 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.
3
Prognosis and risk of recurrence
The prognosis of AO 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.
4
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...
Show more
Diagnostic investigations
History and physical examination: as per ACFAS 2020 guidelines, Assess for instability and alignment in patients with ankle arthritis.
E
More topics in this section
Diagnostic imaging
Medical management
Management of pain, nonpharmacological measures: as per EULAR 2018 guidelines, Offer a personalized management plan with the aim of reducing pain and pain-related distress and improving pain-related function and participation in daily life, guided by shared decision-making, the expressed needs of the patient, clinical assessment, and evidence-based treatment options.
B
Show 9 more
More topics in this section
Management of pain (pharmacotherapy)
Nonpharmacologic interventions
Physical therapy: as per ACFAS 2020 guidelines, Consider offering physical therapy for the treatment of ankle arthritis.
E
More topics in this section
Shoe modifications
Bracing and casting
Supplements
Therapeutic procedures
Intra-articular injections: as per ACFAS 2020 guidelines, Consider administering intra-articular injections of corticosteroids or nonsteroidal agents as an option for the treatment of patients with ankle arthritis.
E
More topics in this section
Biological resurfacing