By Advanced Foot and Ankle Center of San Diego

Ankle arthritis is one of those conditions that sneaks up on people. Unlike hip or knee arthritis, which gets talked about everywhere, ankle arthritis tends to stay under the radar until it’s causing real limitations in daily life. At the Advanced Foot and Ankle Center of San Diego, we see patients every week who have been living with chronic ankle stiffness, swelling, or instability for years before realizing something deeper is going on.

Here’s a clear guide to what ankle arthritis really is, why it happens, and the modern treatment tools available today.

What Is Ankle Arthritis?

Ankle arthritis is the breakdown of cartilage in the ankle joint. Cartilage is the smooth, durable tissue that lets your bones glide over each other without pain. When it wears away, the joint becomes stiff, inflamed, and painful.

While hip and knee arthritis are often age-related, ankle arthritis is usually caused by previous injuries. Even a sprain from years ago can begin a slow cascade of changes inside the joint.

Common Causes

1. Post-Traumatic Arthritis (most common)

More than 70 percent of ankle arthritis cases come from previous injuries:

• Repeated ankle sprains

• Fractures

• Ligament tears

• Chronic instability

Even if the injury “healed,” microscopic cartilage damage can accumulate over time.

2. Osteoarthritis

This is “wear-and-tear” arthritis. It’s less common in the ankle than in other joints, but still possible, especially in:

• Long-distance runners

• People with flatfeet or high arch deformities

• Occupations requiring prolonged walking or standing

3. Inflammatory Arthritis

Conditions such as:

• Rheumatoid arthritis

• Psoriatic arthritis

• Lupus

• Gout

These cause the body’s immune system to attack the joint lining.

Symptoms to Look Out For

Ankle arthritis tends to build gradually. Common signs include:

• Pain with walking or standing

• Morning stiffness

• Swelling around the joint

• A feeling of “grinding”

• Loss of motion

• Difficulty walking on uneven surfaces

• Instability or repeated sprains

Patients often describe their ankle as “not trustworthy.”

How We Diagnose It

At the Advanced Foot and Ankle Center of San Diego, evaluation typically includes:

• Detailed physical examination

• Standing X-rays

• Possible CT or MRI to assess cartilage, bone, or ligament integrity

• Gait analysis if instability or deformity is suspected

Accurate diagnosis is crucial because not all ankle pain equals arthritis.

Non-Surgical Treatment Options

The goal is to reduce pain, improve mobility, and maintain activity levels for as long as possible.

1. Activity and Lifestyle Modifications

Reducing high-impact activities can significantly help.

2. Bracing

Ankle braces or custom devices can support the joint and reduce motion that causes pain.

3. Anti-Inflammatory Medications

NSAIDs may help manage swelling and pain.

4. Physical Therapy

Strengthening the surrounding muscles improves stability and reduces joint stress.

5. Cortisone Injections

These provide temporary relief for moderate pain or flare-ups.

6. PRP or Regenerative Injections

Biologic treatments may help reduce inflammation for certain patients.

Surgical Options

When conservative treatments are no longer effective, surgery can restore function and relieve pain.

1. Ankle Arthroscopy

Minimally invasive. Ideal when arthritis is mild or associated with scar tissue or bone spurs.

2. Realignment or Deformity Correction

If arthritis is partially caused by abnormal alignment, correcting the deformity can offload damaged cartilage and preserve the joint.

3. Ankle Fusion (Arthrodesis)

A reliable treatment for advanced arthritis.
Fusion eliminates motion at the painful joint while maintaining stability and strength.

4. Total Ankle Replacement

For the right candidate, ankle replacement preserves motion and offers excellent pain relief.
Modern implant designs allow for more natural walking and faster recovery compared to older generations.

Living With Ankle Arthritis

Ankle arthritis doesn’t mean giving up the activities you love. With early diagnosis, proper treatment, and modern surgical options, patients can return to a lifestyle that feels active, stable, and pain-controlled.

If you’re struggling with chronic ankle discomfort, the Advanced Foot and Ankle Center of San Diego provides comprehensive, tailored treatment plans to help you get back on your feet — literally.