Arthritis is inflammation and swelling around your joints and nearby soft tissue. It can cause pain and stiffness in any joint in the body and is common in the small joints of the ankle.

Several types of arthritis affect the ankle, including:

  • Osteoarthritis – Degenerative or “wear-and-tear” arthritis is the most common type and is often age-related, becoming a problem for many people after they reach middle age. It may also occur in younger people.
  • Rheumatoid arthritis – The most serious type, it is a chronic disease that can affect multiple joints throughout the body and often starts in the foot and ankle. It usually affects the same joint(s) on both sides of the body.
  • Posttraumatic arthritis – This type can develop after an injury to the ankle, especially a dislocation or bone fracture. An injured joint is about seven times more likely than an uninjured joint to become arthritic, even when the injury has been properly treated.


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In many cases, an arthritic joint will be painful and inflamed. The pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:

  • Pain with motion
  • Pain that flares up with vigorous activity
  • Tenderness when pressure is applied to the joint
  • Trouble moving, walking or putting weight on it
  • Joint swelling, warmth, and redness
  • Increased pain and swelling in the morning or after sitting or resting
  • Difficulty in walking due to any of the above symptoms
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Dr. Chu will discuss your overall health and medical history and ask about any medications you may be taking. He will examine your ankle for tenderness and swelling and closely observe your gait to assess pain, stiffness, how the bones line up, stride and strength.

He will ask questions to understand more about your symptoms. These questions may include:

  • When did the pain start?
  • Where exactly is the pain? Does it occur in one ankle or both?
  • When does the pain occur? Is it continuous, or does it come and go?
  • Is the pain worse in the morning or at night? Does it get worse when walking or running?
  • Have there been previous injuries to the ankle? When did it occur, and how was it treated?
  • X-rays may be taken to allow him to diagnose the severity of arthritis and any joint deformity associated with it. In some cases, a bone scan, CT scan or MRI may be necessary to determine the condition of the bone and soft tissues.

If rheumatoid arthritis is suspected, Dr. Chu may refer you to a rheumatologist who will be able to determine the specific diagnosis.


Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with ankle arthritis can manage their pain, remain active, and lead fulfilling lives. Dr. Chu believes in exhausting all conservative, nonsurgical measures before resorting to surgical intervention.


Dr. Chu will always consider nonsurgical treatments first in the treatment of ankle arthritis.

Some changes in your daily life can help relieve the pain of arthritis and slow the progression of the disease. These changes include:

  • Minimizing activities that aggravate it
  • Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling)
  • Losing weight to reduce stress on the joints

Specific exercises can help increase range of motion and flexibility and help strengthen the muscles in your foot and ankle. An individualized exercise program can be developed that meets your needs and lifestyle. In some cases, physical therapy may worsen joint pain. If this happens, let the doctor know.

Wearing a brace may help improve mobility. In addition, wearing shoe inserts or custom-made shoes with stiff soles and rocker bottoms can decrease joint pain.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can help reduce swelling and relieve pain. Cortisone is a very effective anti-inflammatory agent injected into an arthritic joint, giving temporary relief.


If your pain causes disability and is not relieved with nonsurgical treatment, Dr. Chu may recommend surgery. The type of surgery will depend on the type of arthritis and the impact of the disease on your ankle.

Debridement (cleansing) is a procedure to remove loose cartilage, inflamed tissue and bone spurs from around the joint. During arthroscopy, Dr. Chu inserts a small camera into your ankle joint to guide miniature surgical instruments. This surgery requires tiny incisions. Arthroscopic surgery is most effective when pain is due to contact between bone spurs, and the arthritis has not yet caused a significant narrowing of the joint space between the bones.

Arthrodesis fuses the bones of the joint completely, making one continuous bone out of two or more bones. The goal of the procedure is to reduce pain by eliminating motion in the arthritic joint. During arthrodesis, Dr. Chu removes the damaged cartilage and then uses pins, plates and screws, or rods to fix the joint in a permanent position. Over time, the bones fuse or grow together, just like two ends of a broken bone grow together as it heals. By removing the joint, the pain disappears.

Arthroplasty, also known as total ankle replacement, is a surgical procedure used to replace the ankle joint with an artificial joint to relieve the pain of arthritis and restore the function of the ankle joint. Arthritic changes in the ankle can be caused by wear and tear of the joint over time and can be exacerbated by a severe injury such as a break or dislocation. The degenerative nature of arthritis leads to the loss of cartilage, pain and eventually deformity. The ankle joint replacement is made of metal and high grade plastics that are able to move and function like a healthy ankle. As with other joint replacement procedures, the goal of total ankle replacement is to preserve the function of your ankle, relieve debilitating pain and restore the function of your joint so that you can enjoy your daily activities again. G2 Orthopedics & Sports Medicine is pleased to offer total ankle replacement for patients who have tried conservative nonsurgical remedies such as bracing, anti-inflammatory medication, physical therapy and injections without success.

The Benefits of Total Ankle Replacement

Total ankle replacement surgery is recommended for patients that have advanced arthritis of the ankle and who have not improved with nonsurgical treatments. Refined surgical techniques and advancements in design have significantly improved recovery times and postoperative pain. The main benefits of total ankle replacements, as opposed to the ankle fusion, is to

  • Preserve the motion of the ankle and the up and down motion of the foot for walking
  • Relieve pain associated with end stage arthritis
  • Decrease wear and tear on other joints that may have been burdened by the failing ankle joint

Using a minimally invasive approach, the total ankle replacement procedure can restore mobility and is quickly becoming the standard of care for patients with degenerative arthritis.

What to Expect

During a total ankle replacement procedure, your orthopedic surgeon will remove the damaged portion of the cartilage at the bottom of the shin bone and the top of the foot bone. The prosthetic ankle joint is then placed in the proper position and aligned to ensure that the patient’s gait will be fully restored. Thanks to advancements in design of the prosthesis as well as surgical techniques, the recovery time is weeks rather than months.

For a short time after the procedure, you may be asked to wear a brace or cast to immobilize the joint to give it time to heal. G2 Orthopedics & Sports Medicine will give you detailed post operative instructions to follow to increase the success of your total ankle replacement. After a period of healing, you will regain strength, coordination and range of motion through physical therapy.

If you are interested in learning more about total ankle replacement, or would like to know if you are a candidate for this treatment call (804) 678-9000 today.


If you have – or suspect you have – ankle arthritis, Dr. Chu of G2 Orthopedics and Sports Medicine in Richmond and Midlothian Va. can provide you with a complete diagnosis and a personalized treatment plan. Experience is crucial in treating ankle arthritis, and we see many patients with complicated foot and ankle conditions. For more information on ankle arthritis and treatment options, contact us directly at 804-678-9000 or request an appointment online with our nationally-recognized Dr. Chu and his care team.

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