What type of management options are available for ankle arthritis?

So Mr. Mushtaq, can you please talk us through management for ankle arthritis? So ankle arthritis would be managed like any other arthritis. Firstly we would discuss with the patient the symptoms and try to alleviate some of the symptoms such as pain can be alleviated with painkillers. We start with simple painkillers such as panacetamol then progress to anti-inflammatories like neurophane, naproxen, we're always taking into consideration that these patients are often elderly and these can have effects on their stomach or their kidneys. And then another facet of the same non-operative management would be to do activity modifications so if there's certain types of activities which bring on the pain we would teach the patients to avoid this or change that activity for something else and then if they're also overweight we'd guide them on as to how to lose weight because carrying excess weight puts excess pressure through the ankle joint which causes the symptoms to be more severe and once we've tried the simple methods of management we then may have to proceed to some more interventional management methods such as a cortisone injection, a steroid injection into the ankle joint which can have some benefit and eventually if we can't control the symptoms with non-operative management may have to do an operation. There are two common types of operation that we do for ankle arthritis. One is an ankle replacement and the other is an ankle fusion. Now they differ fundamentally in that with an ankle replacement and this is an ankle replacement you still maintain that arc of movement in your ankle jump so your ankle will still be able to go up and down because you're using a metal on metal replacement with a plastic bearing in between which acts as the bearing surface so you've got two metal bits and a polyethylene plastic bearing in between and this will allow the ankle to still move but with all replacements there is a possibility that this wears out and such as a knee or a hip replacement will wear out an ankle replacement will also wear out and ankle replacements haven't been around for very long so at the moment the latest type of ankle replacements are lasting 7-10 years some are going up to years we don't know exactly how long they're going to last and it's a developing specialty so we will have to be mindful that these replacements will benefit some people but they're not for all patients. The alternative to an ankle replacement would be an ankle fusion. Now an ankle fusion means that the ankle is is held rigid in one place you will still have movement in the rest of the foot so your foot will still move so as you can see this is the ankle joint and I'm holding the ankle still but I'm still getting a reasonable amount of movement distally to the ankle joint and it's estimated that you still retain 50% of movement in the dorsiflexion plantar flexion plane with an ankle fusion so you can still walk, you can run, you can jog, there's still quite a lot of things you can do even with an ankle fusion.