Arthritis

What is it?
Arthritis, meaning inflammation of a joint, can occur at any joint in the human body. Degenerative arthritis means inflammation of a joint due to wear and tear. This condition is called osteoarthritis. Doctors may also use the term “arthrosis” to describe the condition of a worn-out joint. There are many causes for arthritis, and the term is used to describe inflammatory conditions, such as gout, infection, and rheumatoid arthritis.
Who gets it?
In recent years, there has been increasing evidence that osteoarthritis is genetic and has a tendency to occur in families. Research suggests that osteoarthritis that occurs without any injury may be related to the chemical make-up of the cartilage in the joint.
What are the symptoms?
When the joint sustains an injury, the cartilage holding the joint together becomes damaged. The patient does not typically know that damage has been done, and they may not be experiencing significant pain. When asked if the pain limits their activities, the first answer may be “no”. However, in careful questioning, one would ask a patient “what activities are they doing now that they were doing five years ago that they cannot do now because of discomfort in their ankle”. The patient may be surprised by their response.
Because cartilage does not heal or grow back, this causes a defect in the joint. Over time, these defects fill with scar tissue, causing more pain and instability to the joint. The joint ultimately reaches a point when it is no longer able to properly function without significant pain because of the continual damage, resulting in increased inflammation and severe pain.
Diagnosis
Your orthopaedic physician will obtain a family history, considering all factors important in determining the type of arthritis you may have. He will also conduct a thorough physical examination of the joint to evaluate and determine the type and extent of damage to the joint. In this physical examination, the physician will measure the range of motion at the joint, and may draw fluid from the joint to determine if an infection is present. X-rays will then be taken to assess the amount of damage to the joint and determine the proper diagnosis.
Non-Operative Treatment
Arthritis in its mildest form may not need any treatment whatsoever except simple activity modification – avoiding impact activities such as jumping – and recommending activities that are more controlled with less impact such as swimming, cycling, and walking on cushioned surfaces. When arthritis becomes more severe, then the next appropriate step may be medication such as non-steroidal anti-inflammatories (NSAIDs), or other types of medications which are usually prescribed by a rheumatologist. There are many types of mediations that can be utilized as the first line of defense for arthritis prior to considering any surgical procedure.
For patients with stiff and painful joints, bracing is another form of treatment. The bracing may be simple, such as a brace that one would typically use for an ankle sprain.
Operative Treatment
When all these above measures fail and the patient still has significant arthritis limiting lifestyle, then there are three different types of surgical options that can be undertaken to help the patient improve their quality of life. If the joint destruction is on one side of the joint (asymmetric), then the physician can consider an osteotomy (or cutting the bone to change the weight-bearing surface of the joint and help distribute the weight more evenly). This is usually not successfully performed in the ankle, however, it is sometimes considered.
If you suspect that you may have arthritis, then you should see your family physician or internist, as most problems can be treated effectively with anti-inflammatory medications and/or bracing. However, if it is severe enough for surgical intervention, then you should consider being referred to a surgeon