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Appointments and Consultations

To protect you, your family and the staff of RNOH Private Care, we now have the facilities to offer video consultations. Your consultant will tell you if your appointment is to be carried out in this way and their practice secretary will provide you with all of the information you need to do this.

If you are asked to attend RNOH Private Care outpatient centre for your appointment, please ensure that you read the information below and follow any social distancing instructions when you arrive at the hospital.

Coronavirus Information

Stay at Home

  • Only go outside for food, health reasons or work (but only if you cannot work from home)
  • If you go out, stay 2 metres (6ft) away from other people at all times
  • Wash your hands as soon as you get home

Do not meet others, even friends or family. You can spread the virus even if you don’t have symptoms.

What To Do If You Need Medical Help

If you need medical help for any reason, do not go to places like a GP surgery, pharmacy or hospital.

If you have symptoms of coronavirus (high temperature or a new, continuous cough), use the 111 coronavirus service.

If you need help or advice not related to coronavirus:

  • for health information and advice, use the NHS website or your GP surgery website
  • for urgent medical help, use the NHS 111 online service – only call 111 if you're unable to get help online
  • for life-threatening emergencies, call 999 for an ambulance

The tibia and fibula and the ankle bone talus form the ankle joint. This joint allows the foot to move up and down. The sideways movement of the heel principally occurs in the three joints (triple joints) under the talus (sub-talar, talonavicular and calcaneocuboid joints). Smooth articular cartilage covers the bones to allow them to freely glide over one another as the joints move.

Most commonly associated with previous injuries, osteoarthritis may occur spontaneously in the ankle joint. Severe sprains or repeated sprains can damage the articular cartilage of the ankle and lead to progressive arthritis as can fractures around the ankle joint.

 

More Information

The symptoms of ankle arthritis may present as: -

  • Stiffness and pain caused by roughening of the joint surface
  • Inflammation can cause swelling of the ankle joint
  • Early stages - discomfort during exercise which settles with rest
  • Later stages - standing or walking becomes painful, and eventually, pain is experienced even at rest
  • Severe arthritis, the joint surface can erode which may lead to a deformity of the foot with the heel turning in or out when standing.

Non-surgical treatments for ankle arthritis

There are many non-surgical treatments that should be tried before surgery. These include:

  • Diet - Losing weight will reduce the strain on your ankles
  • Medication - Painkillers such as paracetamol or ibuprofen can reduce the pain. Ice packs can help reduce swelling
  • Exercise - Physiotherapy helps build the strength of the muscles, which can take the strain off the joint. We understand that exercise can be painful but you can choose from many non-impact activities such as swimming or cycling
  • Activity modification - Avoid running, squatting and carrying heavy loads. If you are still working, consider changing your role at work
  • Ankle Supports - There are many different types of ankle braces and your physiotherapist can help you find the best option for you
  • Footwear adjustment - Supportive boots, modified shoes or corrective insoles may help
  • Walking aids - A walking stick or cane can be very helpful

You will only be offered surgical treatment if most or all of the above non-surgical measures have failed to control your symptoms, at which point you are considered to have ‘end-stage ankle arthritis’.

Surgical Treatments for ankle arthritis

  • Ankle arthrodesis - an operation to “fuse” or stiffen the ankle joint
  • Total ankle replacement (TAR) - an operation to replace a worn-out ankle joint Ankle arthrodesis is an operation to “fuse” or stiffen the ankle joint.

The diagnosis of ankle arthritis is usually made by a specialist orthopaedic foot and ankle surgeon, based on a history of your condition as well as a careful examination, and a series of standing (weight bearing) X- rays. The X-rays may show a loss of the normal joint space as well as other signs of arthritis.

In most cases, a standing X-ray of the affected foot is all that is needed to determine the severity of arthritis but sometimes it is necessary to carry out further tests such as MRI (Magnetic Resonance Imaging) or CT (Computerised Tomography) scan to look for arthritis of the adjacent (surrounding) joints.

Your specialist may also recommend image-guided injections into one or more joints in order to localise the symptoms and judge the effect that numbing a joint has on your pain.

If you have not previously been diagnosed with a rheumatic condition, your specialist may also order some additional blood tests (to look for conditions such as rheumatoid arthritis or gout).

The cause of ankle arthritis (osteoarthritis) is the end result of the cartilage wearing away.

In primary osteoarthritis, there is no known cause, but it may run in your genes. You and your parents may have swollen painful fingers (Heberden’s and Bouchard’s nodes), and your parents might also have been diagnosed with similar symptoms at a similar age to you.

The majority of ankle arthritis (OA) follows trauma or injury, although inflammation (such as rheumatoid arthritis) can also be a cause. Over 29,000 cases of symptomatic ankle OA are referred to a specialist foot and ankle surgeons each year in the UK.

The ankle is injured more than any other joint. Indeed ankle sprains are one of the most frequent reasons for attending Emergency Departments. The incidence of ankle fractures is increasing especially in young athletes and elderly females. After an unstable ankle fracture, radiographic ankle OA can occur in up to 66% of patients within six years.

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