J Korean Med Assoc.  2013 Oct;56(10):917-923. 10.5124/jkma.2013.56.10.917.

Nonoperative management of ankle arthritis

• Park SB

• KMID: 2193416
• DOI: http://doi.org/10.5124/jkma.2013.56.10.917

Abstract

Although hip and knee osteoarthritis are mostly of primary origin, ankle osteoarthritis is of posttraumatic origin. In sports injuries, the ankle is the second most commonly injured body site after the knee. In addition, compared to the cartilage in the knee joint, ankle cartilage has a higher content of proteoglycans and water, and an increased rate of proteoglycan turnover and synthesis, all of which are responsible for its increased incidence of posttraumatic origin osteoarthritis. Nonoperative management of ankle arthritis typically starts with weight reduction, activity modification, and oral non-steroidal anti-inflammatory drugs, physical therapy, and can progress to gait-aids including a cane, shoe-wear modification, patellar tendon weight-bearing ankle-foot orthosis, and intra-articular injections with corticosteroids or hyaluronic acid.

Keyword

Ankle arthritis; Activity modification; Orthoses; Rehabilitation

MeSH Terms

Adrenal Cortex Hormones
Animals
Ankle
Arthritis
Athletic Injuries
Canes
Cartilage
Hip
Hyaluronic Acid
Incidence
Injections, Intra-Articular
Knee
Knee Joint
Orthotic Devices
Osteoarthritis
Osteoarthritis, Knee
Patellar Ligament
Proteoglycans
Water
Weight Loss
Weight-Bearing
Adrenal Cortex Hormones
Hyaluronic Acid
Proteoglycans
Water

Figure

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  Figure 1 Isometric exercise for quadriceps and hamstring muscles.

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  Figure 2 Intraarticular injection to anteromedial ankle.

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  Figure 3 Intraarticular injection to anterolateral ankle.

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  Figure 4 Patellar tendon weight-bearing ankle-foot orthosis, UCBL (University of California Biomechanics Laboratory) type.

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  Figure 5 Orthopedic shoe with rocker bottom outsole and medial T strap.

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  Figure 6 Lateral heel wedge.

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  Figure 7 Medial heel wedge.

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