Many suffer from chronic painful ankles. The causes of ankle are numerous and
can include chronic sprains, automobile accident injuries, previously fractured
ankles, degenerative joint disease or arthritic conditions such as rheumatoid
arthritis. The common factor in all these causes is the damage of the joint
surface (cartilage) which causes inflammation and pain. Fortunately there is are surgical and non-surgical methods to
temporarily and, in many cases, permanently stop the pain.
Resolving inflammation
Non-steroidal anti-inflammatory medications (NSAIDs)- Commonly
prescribed medicines such as ibuprofen, naproxen, Celebrex are used to reduce
chronic and acute inflammation. However, judicious use is warranted to prevent
chronic kidney injury. Typically, 10-14 day courses are recommended. If the
course fails then another treatment modality should be attempted.
Injectable anti-inflammatory medications- So called "cortisone'
injections can be effective and safe when used carefully. Injections into
joints should always be soluble (non-crystalized) steroids to prevent further
damage to the cartilage surfaces. Low doses are often used and combined with
local anesthetics which immediately reduce or eliminate pain. The effects of
injectable steroids may be shrot lived, but in some cases can convert the body
over to permanent pain relief.
Injectable lubricating enhancements- new injectable solutions such as
Synvisc or Hyalgan are polymer injectable liquids which contain cartilage
healing medicines combined with lubricants. These preparations contain
glucose-amino-glycan (GAGs) and chondroitin sulfate which stimulate cartilage
healing and lubrication and can reduce pain and inflammation.
Removing or eliminating damaged cartilage
Minimally invasive Arthroscopic Ankle Surgery uses a video camera on
one side of the ankle joint and a debridement device called an abrader to clean
out inflamed tissue of the joint.
Open Ankle arthroplasty is performed by making one or two incisions on
each side of the ankle to gain access to the ankle joint in order to remove and
remodel damaged cartilage and bone. This procedure is performed when more
extensive surgery is needed to competently clean out the joint. This is
especially so when large amounts of bone spurring make using an arthroscope
unfeasable.
