Osteoarthritis Ankle

Arthritis Arthritis is the general term for chronic pain in the joints the fingers, wrists, elbows, shoulders, knees, ankles, and feet. There are two types of arthritis— rheumatoid arthritis, which results from an inflammation of the thin membranes that line the joints, and the more common osteoarthritis, which results from a... 

CN. Prospective study of the safety and efficacy of hylan G-F 20 (Synvisc ) in patients with symptomatic ankle osteoarthritis. In American College of Rheumatology 70th Annual Meeting, Washington, D.C., November 10-15,2006. 

Viscosupplementation via intra-articular hyaluronic acid injections is a conservative treatment modality to be used in conjunction with other conservative management modalities including activity modification, physical therapy, analgesics, nonsteroidal anti-inflammatories (NSAIDS), and intra-articular corticosteroid injections. It is only approved by the FDA for treating osteoarthritis of the knee. Off-label use has been reported for treatment of osteoarthritis affecting the earpometacarpal joints of the thumb, apophyseal joints of the lumbar spine, hip, ankle, and foot [1, 34, 40, 92, 101]. 

Medical pain 5% ibuprofen cream is found to be useful in treating acute ankle sprains and knee osteoarthritis. 

Diclofenac gel is indicated for the relief of the pain of osteoarthritis of the joints amenable to topical treatments such as the knees and those of the hands. Diclofenac patch is indicated for the topical treatment of acute pain due to minor strains, sprains and contusions [2,3]. In controlled trials during the premarketing development approximately 600 patients with minor sprains, strains, and contusions were treated safely with diclofenac patch for up to 2 weeks [4j. A randomized, double-blind, placebo-controlled, trial evaluated the efficacy and tolerability of diclofenac patch, self-administered every 12 h to injury site, in 384 patients aged 18-65 years with minor soft tissue injury and moderate to severe pain intensity >5 (0-10 scale). The most common injuries were contusion (42.6%), strain (31.1%), and sprain (24.4%) most common sites were ankle, shoulder, knee, and foot (67.3%). Patients treated with diclofenac patch experienced improved mean pain scores (40.4% of baseline score) vs. patients using placebo (47.4%, P < 0.05) with an overall pain reduction of 14.8% (Figure 52.3). Patients treated with the patch reached pain resolution 3 days sooner than those in the placebo group (median 10.0 vs. 13.5 days, P = 0.01). Patient response to treatment was rated good to excellent 57.8% for the diclofenac patch vs. 48.4% placebo (P < 0.01). 

Causes. Osteoarthritis is usually produced by a constant strain on a joint which produces a wearing away of the articular cartilage within the joint, especially the weight-bearing joints— the knees, hips, ankles, and spine. Overweight and stress can aggravate the disease. (See Fig. A-38.)... 

Ali MS, Higgins GA, Mohamed M. Intermediate results of Buechel Pappas unconstrained uncemented total ankle replacement for osteoarthritis. J Foot Ankle Surg 2007 January-February 46(l) 16-20. 

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