Foot & Ankle Arthritis: Treating the Pain

Living with foot or ankle arthritis can be painful, and although it is uncommon, it can affect one’s quality of life. At Good Samaritan Hospital, orthopedic surgeon specializing in foot and ankle disorders Jonathan Saluta, M.D. offers insight into foot and ankle arthritis diagnosis and treatment.
According to Dr. Saluta, arthritis in the foot or ankle is commonly due to a previous injury that a patient suffered. Sometimes patients do not realize the severity of a past injury, and arthritis can occur as the result of a simple sports injury such as an ankle sprain. “An injury like this can cause trauma to cartilage inside the joint, and over the course of many years, the joint may undergo degenerative changes,” stated Dr. Saluta. “The cartilage inside the joint starts wearing away.”
Foot and ankle arthritis can vary in severity. Signs and symptoms of arthritis may include an achy pain in the joint, swelling around the joint, or feeling warmth in the joint. More severe arthritis may manifest as a grinding sensation in the joint in which bone is rubbing on another bone due to cartilage deterioration. This action can cause a loss of joint congruity and deformity.
According to Dr. Saluta, the best way to diagnose arthritis is to get an exam by a foot and ankle specialist. X-rays are most helpful for the physician; however, milder cases may require a Computed Axial Tomography (CAT) scan or Magnetic Resonance Imaging (MRI) scan for diagnosis. Once arthritis has been diagnosed, several steps can be taken to alleviate pain in the joint.
“My initial treatment for midfoot or forefoot arthritis is to reduce motion in the joint by use of a stiff orthotic or shoe modifications,” said Dr. Saluta. “If the arthritis is located in the hindfoot or ankle, then a brace can be applied to ease the symptoms. Another treatment is to inject the ankle joint with cortisone to temporarily reduce inflammation inside the joint.
In severe cases of arthritis which have failed conservative treatment, surgery may be recommended. One option is to perform an arthroscopic procedure to clean out scar tissue, drill lesions to stimulate cartilage regrowth, and remove loose pieces or cartilage floating inside the joint. “Arthroscopy is an outpatient procedure which requires two small incisions in the front of the ankle, each approximately half a centimeter in length,” said Dr. Saluta. “The arthroscope is like a telescope the size of a pencil which is used in conjunction with another device which smoothes out the cartilage or removes loose bodies from the joint.”
Another surgical option is to fuse the joint. “In this procedure, degenerative cartilage is removed from the joint and the bones heal together to form one bone,” said Dr. Saluta. Although this surgery usually results in restricted mobility, patients with arthritis already have a limited range of motion in the joint.
A final option for severe arthritis is joint replacement. This procedure should be performed by a specialist who will use a metal and plastic prosthesis to replace the joint. The operation usually provides good pain relief, and some joint motion is preserved. Technically, the ankle is a difficult joint to replace, and only a small number of patients qualify. “There is a list of criteria that you have to pass before total ankle replacement is recommended,” said Dr. Saluta.
The onset of arthritis is hard to predict, and Dr. Saluta does not recommend drastic preventive measures for those looking to avoid arthritis. “Most of the time you don’t even realize you have damaged your cartilage,” he said. “My advice is to stay active rather than be sedentary in fear of developing arthritis.”
For a referral to a Good Samaritan Hospital board-certified specialist, please call(213) 482-2744

Colon Cancer Awareness Event March 17, 2012

Good Samaritan Hospital and The WunderGlo Foundation team up to raise awareness about colon cancer. This seminar will include presentations by physicians on topics such as early detection, nutrition and treatment, including testimonials from Colon Cancer Warriors!
Join us for this very informative and memorable event! Reserve your seat by calling 800.472.2737.