What is Ankle Arthritis?

Ankle arthritis is most often the result of gradual joint degeneration following trauma. The symptoms include pain and stiffness in the ankle joint, and in many cases, the way you walk (your gait) is negatively impacted. Non-operative treatment usually consists of rest, activity modification, NSAID's, injection, and sometimes bracing.

 

Surgical treatments include joint preservation ankle distraction surgery, ankle fusion, and ankle replacement. While fusion and joint replacement can be effective treatments, both have limitations. Namely fusion leads to loss of ankle motion and puts excessive force on adjacent joints of the foot which can lead to premature arthritis and pain. While ankle replacement does preserve ankle motion, a lot of ankle bone must be removed to insert the implant and the longevity is not known.

 

Dr. S. Robert Rozbruch is an expert in joint preservation surgery with ankle distraction. This is a good conservative treatment that has been very effective in his hands and does not burn bridges for the future. The usual components of this approach include:

 

1. Clean out the ankle arthritis and remove bone spurs in front of the ankle

 

2. Perform microfracture on areas where there is full thickness cartilage loss. Microfracture entails making 1.8 mm drill holes in the bone that allows bone marrow and stem cells to reach the surface of the joint for cartilage regeneration.

 

3. Add additional mesenchymal stem cells from your bone marrow aspiration concentrate to facilitate cartilage regeneration.

 

4. Perform tendon lengthening to improve ankle motion.

 

5. Perform ankle distraction with application of a hinged external fixator. This unloads the ankle joint and provides room for new cartilage to grow while maintaining joint mobility.

 

6. If there is deformity present, this is corrected at the same time.

 

Dr. Rozbruch's results have been very good. One year after surgery 90% of patients feel much better than before the surgery and are happy they did the procedure. Patients typically see increased joint space, improved density of subchondral bone, and resolution of subchondral cysts. In summary, with ankle distraction surgery you can expect to see reversal of arthritis, diminished pain, and improved mobility in our patients.

 

535 East 70th Street  •  New York, NY 10021