Elsevier

Foot and Ankle Clinics

Volume 18, Issue 3, September 2013, Pages 411-426
Foot and Ankle Clinics

Ankle Osteoarthritis: Etiology, Diagnostics, and Classification

https://doi.org/10.1016/j.fcl.2013.06.001Get rights and content

Section snippets

Key points

  • Osteoarthritis is a constantly growing problem in health care with approximately 1% of the world’s adult population affected by ankle osteoarthritis.

  • Previous trauma is the most common reason for ankle osteoarthritis.

  • The mental and physical disability associated with end-stage ankle osteoarthritis is at least as severe as that associated with end-stage osteoarthritis of the hip joint.

  • Conventional radiological imaging of ankle osteoarthritis include 4 weight-bearing radiographs: anteroposterior

Etiology of ankle osteoarthritis

Osteoarthritis (OA) as a debilitating chronic disease is a growing problem in health care.1, 2, 3 Approximately 1% of the world’s adult population is affected by ankle OA, which results in pain, dysfunction, and impaired mobility.4, 5 The mental and physical disability associated with end-stage ankle OA is at least as severe as that associated with end-stage hip OA.4 Whereas the etiology of hip and knee OA is well understood and highlighted in numerous clinical studies, research related to

Early onset and development of posttraumatic ankle osteoarthritis

The etiology of posttraumatic OA and its pathomechanical basics have been studied extensively. Posttraumatic OA may result from irreversible cartilage damage that occurred at the time of injury, and chronic cartilage overloading resulting from articular incongruity and instability.21, 22 Horisberger and colleagues23 identified the latency time between injury and end-stage posttraumatic ankle OA as 20.9 years, with a range between 1 and 52 years, in a clinical study including 257 patients (270

Clinical Study of Ankle Osteoarthritis

The functional limitations in patients with ankle OA are often substantial and should not be trivialized. Glazebrook and colleagues4 performed a Level I study comparing the health-related quality of life between patients with end-stage ankle and hip OA. Patients with ankle OA had significantly worse mental component summary scores, role-physical scores, and general health score, as assessed using Short Form-36 (SF-36) generic outcome instruments. The investigators concluded that the mental and

Ankle osteoarthritis classification system

Takakura and colleagues19, 69 used weight-bearing radiographs to classify ankle OA into 4 stages (Table 3). For clinical use the investigators simplified the classification, describing stage 1 as early, stages 2 and 3 as intermediate, and stage 4 as late.19, 69 Tanaka and colleagues70 slightly modified the Takakura classification as follows. Stage 1: early sclerosis and formation of osteophytes without narrowing of the joint space; Stage 2: narrowing of the medial joint space; Stage 3A:

Summary

Ankle OA is less common than OA of the other major joints of the lower extremity (knee or hip). However, the clinical importance of ankle OA should not be underestimated. Patients with ankle OA have a lower quality of life and substantial functional limitations.4, 32 Unlike the hip and knee joint, the ankle joint is often affected by posttraumatic OA.5, 6 The diagnosis of osteoarthritic ankle joint starts with clinical assessment, and includes assessment of alignment and stability and

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