Conservative Treatment of Asymmetric Ankle Osteoarthritis

Total Ankle Replacement

“…45 (51) 684 (722) 47 (50) 49 (50) 245 (257) 80 (83) 111 (123) 61 (62) 45 (52) 126 (132) 43 (50) 396 (404) 80 (84) 82 (82) 95 (100) 229 (229) 106 (106) 233 (240) 639 (639) 593 (593) 100 (100) 501 (517) 515 (515) 303 (306) 103 (103) 65 (68) 390 (406) 66 (66) 226 (233) 96 (100) 90 (99) 6218 (6389) Etiology of ankle osteoarthritis, % (absolute values) Primary 25.5% (13) 9.5% (69) 6.0% (3) 16.0% (8) 20.6% (53) 33.7% (28) 52.8% (65) 19.4% (12) 50.0% (26) 46.2% (61) 54.0% (27) 16.6% (67) 25.0% (21) 34.2% (28) 26.0% (26) 13.8% (32) 52.8% …”

“…This includes intensive physiotherapy (local antiphlogistic therapy, muscle and movement exercises to prevent stiffness of the joint, muscle strength development, gait training) and possibly intra-articular hyaluronic acid viscosupplementation and orthopedic adaptation of footwear (13,14).…”

Intra-articular Injections in the Treatment of Symptoms from Ankle Arthritis: A Systematic Review

“…Earlier reviews commented on how the efficacy of HA may vary according to its treatment characteristics, such as dosage, molecular weight, and number of injections. 6,27,31 On the other hand, HA also showed no difference in outcomes relative to 2 different active therapies, exercise, and botulinum toxin injections, but each comparison was limited to just 1 small RCT. 16,29 The evidence on CS, PRP, and MSC injections is even less well defined than the research on HA.…”

“…Although many therapies exist, there is presently no consensus or guideline statement on a proper treatment algorithm for these patients, with most decisions being based on surgeon experience, skill set, and patient's values and preferences. 27,31 Prior reviews, including 1 Cochrane review, have concluded that, although the evidence is mostly low-quality and preliminary, HA is promising and deserves further investigation, particularly in ankle arthritis due to OA; they also recommended its use for patients who have an inadequate response to simple analgesics or those who are not fit for surgery, though there is uncertainty as to which patients (based on age or arthritis severity) would benefit most and on the proper dosage. 6,21,27,31 Table 1 highlights the fact that many different HA preparations are on the market, and each is unique in its molecular makeup and recommended injection regimen.…”

Ankle Osteoarthritis

“…Patients with a body mass index (BMI) greater than 25 have a 1.5 times higher risk for the diagnosis of foot and ankle OA [ 25 ], with the risk increasing in people with rising BMI and in patients over 30 years of age at the time of injury and with increasing length of time since surgery. The probability of developing posttraumatic ankle OA among patients having three or more risk factors was 60-70 % in an 18-year follow-up study [ 22 ].…”