Osteoarthritis of the Ankle

Osteoarthritis of the ankle, caused by wear and tear of the joint, results in swelling, pain, and foot deformity. Recommended treatment options include total joint replacement and arthrodesis. At the Paley Institute, we offer an alternative: joint preservation techniques that retain the patient’s natural ankle joint and ankle motion. 

We use a technique that involves distraction of the joint with external fixation. This procedure is a viable alternative to arthrodesis and / or joint replacement, with the added benefit of restoring normal joint anatomy. The technique uses the principle of ligamentotaxis to restore normal joint space, improving joint loading, and providing an environment in which the joint cartilage can recover.

Indications for ankle joint distraction include:

  • Congruent joint surface
  • Ankle pain
  • Reduced ankle mobility
  • Moderate to severe osteoarthritis

Joint distraction may also be efficacious in treating avascular necrosis of the talus.

Ankle distraction works by transferring the weight-bearing forces from the cartilage to the external fixator. This relieves pressure on the cartilage, allowing it heal. Weight bearing in the fixator also allows for continued intra-articular fluid pressure and increased synovial fluid, providing further cartilage restoration. Fixation also allows for reduction in the subchondral bone density, increasing the resiliency of the joint. These changes allow the osteoarthritic cartilage to regenerate.

Next Page: Treatment Strategies