This retrospective series of 639 consecutive patients characterizes the etiology of symptomatic ankle arthritis at a tertiary orthopedic center. It asks why ankle arthritis develops and compares its causes to those of hip and knee arthritis. Only Kellgren/Lawrence grade 3 or 4 cases were included.
Ask any patient presenting with ankle arthritis about prior trauma — fractures, sprains, and instability episodes. In 70% of cases, trauma is the cause, and even a single sprain with persistent pain may represent an unrecognized full-thickness chondral injury.
This paper is why ankle arthritis is managed differently from hip and knee arthritis. The dominant pathology is post-traumatic, not wear-and-tear, which means prevention strategies (anatomic fracture reduction, instability repair) matter far more at the ankle than at other joints.
Primary OA is the indication for total hip and knee replacement, but post-traumatic arthritis is the indication for ankle arthrodesis. When you see a 50-year-old needing an ankle fusion, the cause is almost certainly a fracture or ligament injury from decades earlier — not age-related degeneration.
Half of patients labeled as having primary ankle OA have underlying hindfoot malalignment (cavovarus or planovalgus). Always assess hindfoot alignment before attributing ankle arthritis to idiopathic causes.
This retrospective series of 639 consecutive patients characterizes the etiology of symptomatic ankle arthritis at a tertiary orthopedic center. It asks why ankle arthritis develops and compares its causes to those of hip and knee arthritis. Only Kellgren/Lawrence grade 3 or 4 cases were included.
Ask any patient presenting with ankle arthritis about prior trauma — fractures, sprains, and instability episodes. In 70% of cases, trauma is the cause, and even a single sprain with persistent pain may represent an unrecognized full-thickness chondral injury.
This paper is why ankle arthritis is managed differently from hip and knee arthritis. The dominant pathology is post-traumatic, not wear-and-tear, which means prevention strategies (anatomic fracture reduction, instability repair) matter far more at the ankle than at other joints.
Primary OA is the indication for total hip and knee replacement, but post-traumatic arthritis is the indication for ankle arthrodesis. When you see a 50-year-old needing an ankle fusion, the cause is almost certainly a fracture or ligament injury from decades earlier — not age-related degeneration.
Half of patients labeled as having primary ankle OA have underlying hindfoot malalignment (cavovarus or planovalgus). Always assess hindfoot alignment before attributing ankle arthritis to idiopathic causes.