Ankle Osteoarthritis

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Patient Information

https://secureservercdn.net/198.71.233.138/c3i.9cb.myftpupload.com/wp-content/uploads/2019/12/ankle-arthritis.pdf

https://www.bofas.org.uk/Portals/0/site-files/Patient%20info%20files/Ankle%20Arthritis%20-%20Patient%20Information.pdf?ver=2014-06-23-220208-000

http://www.patient.co.uk/pdf/4304.pdf

GP Information

Background Information

  • Advise patients that ligaments may take longer to recover than fractures
  • Defined as OA of the tibial-talar joint.
  • 2/3 of cases are post traumatic
  • Patients typically complain of pain on weight-bearing and stiffness.
  • Examination may reveal a joint effusion, with painful and restricted ROM +/- deformity and crepitus.

Investigation Guidelines

  • Blood tests and radiography are not usually indicated as part of a primary care assessment of suspected osteoarthritis.

Management Recommendations

NICE recommend Core treatment should be offered to all patients prior to referral for surgical opinion.

  • Provide verbal and written information to patient.
  • Advise strengthening exercises and aerobic fitness training including cycling and swimming. Weight loss.
  • Ankle brace or orthotic.

Analgesia should include:

  • Regular paracetamol
  • Topical NSAIDs
  • Consider oral NSAIDs, opiods Utilise the NHS shared decision making aids (URL)

Referral Indications

  • Diagnostic uncertainty
  • Failure of conservative measures.
  • Pain, stiffness, reduced function impacting on QoL.
  • Referral for physiotherapy / orthotics
  • Referral for steroid injection
  • Referral for consideration of arthroscopy, fusion or replacement.