Osteoarthritis of the ankle

Osteoarthritis of the ankle is a pathological degenerative change in the ankle – also often referred to as a ‘wear and tear disease’. It occurs less frequently than osteoarthritis of the knee or hip, but can occur as a result of injuries, such as ankle fractures.

An increasing number of younger adults are also affected by osteoarthritis of the ankle.

Whether the osteoarthritis is treated conservatively or surgically can only be decided after a comprehensive examination has been carried out by a specialist.


As the disease progresses, the joint deteriorates and the pain in the ankle increases. The patient may also experience impaired mobility and reduced resilience.

The following are known symptoms of the disease:

  • restricted movement
  • occurrence of friction noises
  • ‘start-up pain’
  • exertion-induced pain when walking
  • rest pain after getting up
  • rapid fatigue of the joint under exertion
  • increased stiffness of the ankle
  • swelling and inflammation


To date, research has not been conducted into all of the causes that lead to osteoarthritis of the ankle.

Osteoarthritis of the ankle is usually caused by wear and tear of the articular cartilage or as a result of joint injuries.

In contrast to other types of osteoarthritis, osteoarthritis of the ankle can also be caused by other conditions, such as:

  • sprained ankle
  • ligament strain
  • torn ligament
  • broken bones near the ankle
  • gout
  • rheumatism
  • family predisposition
  • overexertion due to obesity or intense exercise


The treatments for osteoarthritis of the ankle are intended to improve joint mobility and relieve pain.

Both conservative and surgical methods can be used.

Conservative therapies

  • Intra-articular treatment (inside the joint capsule)
  • Physiotherapy
  • Orthopaedic methods

Surgical treatment

If conservative therapy measures are not able to provide adequate relief from the symptoms, surgical interventions may be necessary.

A basic distinction is made between:

  • joint-preserving surgery: e.g. removal of osteophytes (bone growths that can disrupt joint function; correction of deformities)
  • joint-stiffening surgery: in advanced osteoarthritis, the bones of the ankle may be fused to allow pain-free weight-bearing, or the joint may be replaced with an artificial ankle joint


Aftercare depends on the treatment method used.


It is really important to immobilise the originally movable joint so that the bones can grow together in a stable manner. In addition to the screws used, this can be done using a plaster cast or splint.

In a normal healing process, the joint can be fully bear weight again after about six to eight weeks. Crutches are used up until this point. The joint is usually fully healed after three months.

Artificial ankle joint

More intensive aftercare is required for patients with an artificial ankle joint.

If the wound is healing normally, physiotherapy begins after about a week. The joint is mobilised two to three times a week under supervision. It is also important for the patient to do exercises at home to restore the function of the joint.

Compared to casting or splinting, the artificial joint can bear weight earlier. However, it is still advisable to use crutches for the first six weeks. In certain cases, rehabilitation can take up to a year. Normally, the joint is healed after four to six months.


Can I do sports again after ankle surgery?

The kind of sport or exercise you can do after surgery depends on the type of treatment you have had. If the ankle has been splinted or cast, various sports are possible. Types of sport in which the foot can easily be twisted are not recommended for those with an ankle replacement. In addition, excessive stress leads to faster wear of the prosthesis. However, sports such as cycling, swimming or hiking are possible.

How do I prevent ankle osteoarthritis?

Regular, low-impact exercise can prevent osteoarthritis of the ankle. This includes sports such as cycling or swimming. It is also important to make sure you maintain a healthy lifestyle and a healthy, normal weight.

Can osteoarthritis be detected through blood tests?

There are no typical markers for osteoarthritis that show up in a blood test. Osteoarthritis of the ankle can only be diagnosed by a foot specialist.

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