Healthcast: Treating Ankle Arthritis


A stumble on the sidewalk, a turn in high heels, or a fall on the sports field, ankle sprains happen to just about everyone. Most heal successfully on their own, but about five or ten percent of the time severe sprains, or even a bone break, can cause arthritis. For a growing number of patients, total ankle replacement surgery has been the solution.

81-year-old Hazel “Joyce” McNeil works out almost every day.

“I like it cause it’s whole body.” McNeil said.

Years ago McNeil would not have been able to workout because of severe pain in her ankle. It started with a wintery day half a century ago.

McNeil said, “I fell on a piece of ice that was probably the size of a dime.”

Her leg broke in seven places. Doctors reset the bone, but it was never quite the same.

“Because of all those years, 40-50 years of her walking on a little bit mal-aligned leg, over time the ankle joint was worn down.” Clifford Jeng, MD, an Orthopedic Surgeon at Mercy Medical Center in Baltimore, Maryland explained.

McNeil lived with arthritis until she was in her sixties.

“I felt so miserable and I limped so much that it tired me out. I was ready.” McNeil stated.

Dr. Clifford Jeng says instead of fusing the bones, more patients are turning to total ankle replacement to relieve chronic pain.

“We can keep the motion with an ankle replacement, they have a more normal gait and the pain relief has been shown to be equivalent to an ankle fusion.” Dr. Jeng said.

Dr. Jeng says a new generation of replacements means surgeons remove a lot less bone. The replacements are successful in eighty percent of the patients over ten years. McNeil is going on fifteen years, keeping her on her feet and independent.

“I don’t want to be a burden to anybody.” McNeil said.

The gold standard for treating chronic ankle pain has been fusion, but Dr. Jeng says many patients don’t like the stiffness that comes with that surgery. He also says total ankle replacement is not the best option for everyone. Those with diabetes or other underlying health conditions would not be good candidates for the surgery.

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