Preventing Ankle Arthritis After Sprain

About two years ago, I sprained my ankle big time. It never has healed properly. In fact, I think I may have resprained it several times just in the last few months. Now I'm worried that I'll end up with arthritis in that joint. Can I do anything to prevent this from happening?

Ankle arthritis can be caused by trauma. A sprain that never completely heals properly can cause significant ankle instability and foot malalignment. Over time, this type of imbalance can lead to excessive joint wear and tear. Painful, debilitating post-traumatic arthritis may be the end result.

Now is a good time to address your concerns. An orthopedic evaluation may serve you well. X-rays of the ankle may be taken. This will show the joint spaces and articular surface of the joint. Any signs of joint space narrowing, uneven surfaces, or the presence of bone spurs may point to a diagnosis of arthritis.

Many people have significant signs of arthritic changes without symptoms, so doctors don't put a lot of stock in X-ray results. They can provide some additional information not possible with a physical exam.

After taking a history and conducting a physical exam, the orthopedic surgeon will be able to advise you of your treatment options. A physiotherapist can help identify areas of weakness and instability and plan an appropriate rehab program. Muscle strengthening is important but treatment will also address joint proprioception (sense of position) needed to prevent chronic reinjury.

If there is too much ligamentous damage, surgery may be needed. A conservative rehab program is advised before having surgery, so that's the first step even for severely damaged soft tissue structures.

Loretta B. Chou, MD, et al. Osteoarthritis of the Ankle: The Role of Arthroplasty. In Journal of the American Academy of Orthopaedic Surgeons. May 2008. Vol. 16. No. 5. Pp. 249-259.
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