As in most degenerative problems, the initial management can include a period of rest, change of activities and anti-inflammatory medications. Finding a pair of shoes that helps to relieve the pain is also useful. Most family physicians can adequately manage the majority of such conditions conservatively.
If a period of rest or oral anti-inflammatory medications does not adequately relieve the pain, then a referral to the orthopaedic surgeon might be necessary.
Having made the proper diagnosis, your surgeon will discuss with you, the options available. If you have tried conservative options but have had no relief of symptoms, you might be offered surgery.
Surgery can range from key-hole or arthroscopic surgery, to major deformity corrections. Painful deformities can be reliably corrected via osteotomies (bone re-shaping) without sacrificing or fusing any joints. With modern internal fixation devices, the outcome of surgery has improved and patients can expect to move about fairly conveniently.
In advanced deformity with arthritis, fusion might have to be done. This will mean that the diseased joints are permanently held together and movement is sacrificed. These are usually salvage procedures for end stage diseasesTherefore, early diagnosis and treatment might allow us to avoid this. In the ankle however, advanced osteoarthritis can be treated with total ankle replacement. This involves implanting an artificial ankle joint.
Soft tissue injuries can variably be treated by surgical repair or by transplanting healthy soft tissue to the damaged area (reconstruction). Common procedures performed would be ligament reconstruction of an unstable ankle and arthroscopic (key-hole) ankle surgery to resect painful soft tissue impingement at the ankle.
