Ankle Osteoarthritis

Ankle osteoarthritis is far less common than hip or knee OA and is usually post-traumatic — the result of prior fracture, recurrent instability, or osteochondral lesions rather than primary wear. It is a major cause of long-term disability after ankle fractures. The tibiotalar joint degenerates with cartilage loss, subchondral sclerosis, and osteophyte formation, causing pain, stiffness, and difficulty walking on uneven surfaces.

Weight-bearing AP, lateral, and mortise ankle X-rays are the primary imaging study. CT provides superior detail of osteophytes and subchondral cysts. MRI assesses cartilage and soft-tissue pathology. Alignment of the hindfoot must be assessed — varus or valgus deformity drives asymmetric ankle loading.

1. Ankle corticosteroid injection

   Provides temporary relief; useful for flares.

2. Viscosupplementation (hyaluronic acid)

   Limited evidence but may provide months of relief.

Surgery is offered when pain significantly limits function and conservative measures have failed.

External patient-education references and related OSI pages for additional background:

• Britannica — Osteoarthritis
• Britannica — Ankle (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language