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Ankle Osteoarthritis
From WikiSM
Contents
Other Names
- Osteoarthritis of the ankle
- Degenerative joint disease (DJD) of the ankle
- Tibiotalar Osteoarthritis
- Fibulotalar Osteoarthritis
- Ankle Arthritis
Background
- This page refers to osteoarthritis (OA) of the Ankle Joint
- Herein referred to as 'Ankle OA'
History
Epidemiology
- Approximately 1% of the adult population have ankle OA[1]
Pathophysiology
- Osteoarthritis (Main)
- Progressive, degenerative condition
- Result of loss of articular cartilage
- Typically becomes more severe, frequent, and debilitating over time
Etiology
- Primary Ankle OA [1]
- Secondary Ankle OA
- Rheumatoid Arthritis
- Hemochromatosis
- Hemophilia
- Clubfoot
- Avascular talus necrosis
- Osteochondrosis dissecans
- Post infectious arthritis
- Posttraumatic Ankle OA (most common)
- Ankle ligament lesions
- Tibial plafond fracture
- Tibial shaft fracture
- Talus fractur
- Varus ankle alignment
Associated Conditions
- See secondary OA above
Pathoanatomy
Risk Factors
- Older Age
Differential Diagnosis
- Fractures & Dislocations
- Muscle and Tendon Injuries
- Ligament Injuries
- Bursopathies
- Nerve Injuries
- Arthropathies
- Pediatrics
- Fifth Metatarsal Apophysitis (Iselin's Disease)
- Calcaneal Apophysitis (Sever's Disease)
- Triplane Fracture
- Other
Clinical Features
- History
- Exam
- Specialty Test
Evaluation
Radiographs
- Standard Radiographs Ankle
- All views must be weight-bearing
- AP view
- Lateral view of the foot
- Mortise view of the ankle
- Saltzman view of the hindfoot
Ultrasound
MRI
- Used to evaluate cartilage and periarticular soft tissues and tendons around the ankle joint
CT
- Single-photon emission computed tomography/computed tomography (SPECT-CT) [2]
- Used to evaluate degenerative changes and their biological activities
- Helps assess other osteoarthritic changes in other nearby bone
Classification
- Grading System by Giannini [3]
- Stage 0 - Normal joint or subchondral sclerosis
- Stage 1 - Presence of osteophytes without joint-space narrowing
- Stage 2 - Joint-space narrowing with or without osteophytes
- Stage 3 - Subtotal or total disappearance or deformation of joint space
- Grading System by Cheng (Based on Weight-Bearing Radiographs) [4]
- Stage 0
- No reduction of the joint space
- Normal alignment
- Stage 1
- Slight reduction of the joint space
- Slight formation of deposits at the joint margins
- Normal alignment
- Stage 2
- More pronounced change than mentioned above
- Subchondral osseous sclerotic configuration
- Mild malalignment
- Stage 3
- Joint space reduced to about half the height of the uninjured side
- Rather pronounced formation of deposits
- Obvious varus or valgus alignment
- Stage 4
- Joint space has completely or practically disappeared
- Stage 0
Management
Prognosis
Nonoperative
Operative
Rehab and Return to Play
Rehabilitation
Return to Play
Complications
- Chronic Pain
See Also
- Internal
- External
- Sports Medicine Review Ankle Pain: https://www.sportsmedreview.com/by-joint/ankle/
References
- ↑ 1.0 1.1 Valderrabano V, Horisberger M, Russell I, Dougall H, Hintermann B. Etiology of ankle osteoarthritis. Clin Orthop Relat Res. 2009;467(7):1800-1806. doi:10.1007/s11999-008-0543-6
- ↑ Barg A, Pagenstert GI, Hügle T, et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin. 2013;18(3):411-426. doi:10.1016/j.fcl.2013.06.001
- ↑ Giannini S, Buda R, Faldini C, et al. The treatment of severe posttraumatic arthritis of the ankle joint. J Bone Joint Surg Am 2007;89 Suppl 3:15.
- ↑ Cheng YM, Huang PJ, Hong SH, et al. Low tibial osteotomy for moderate ankle arthritis. Arch Orthop Trauma Surg 2001;121(6):355
Created by:
John Kiel on 7 July 2019 08:08:56
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Last edited:
3 October 2022 23:47:36
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