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Surgery alternatives for ankle arthritis?

Q) I injured my ankle when I was in my teens and am now suffering with severe arthritis in this joint. It has been relieved by three lots of injections but this is no longer possible. After x-rays, I have been told that I could have my ankle fused. I am 83 and have had a knee and two hips replaced and I do not think I would be able to cope with this operation. I am taking many painkillers, find walking very difficult and rely on a mobility scooter to get around. Any suggestions please, as to further remedies?

Mrs A Mulligan, Rustington, Littlehampton, West Sussex

A) Oh, if only there were a simple solution. Injections of steroids (cortisone) often work for what I presume is osteoarthritis but for a varying amount of time. Sometimes relief is for days, sometimes weeks and it can vary. Injections of steroids into weight bearing joints such as the ankle are not recommended more than four times per year. You could have further injections and sometimes the injection works better if you have it done under ‘screening’, that is with some form of imaging such as x-ray or ultrasound to guide the injection to the right spot. Other drugs have been used to inject the ankle – you could ask your rheumatologist about hyaluronic acid injections. New drugs for the pain of osteoarthritis are in the pipeline but not yet generally available. And, finally, don’t write off an operation entirely. Joint fusion at the ankle can be a very successful way of controlling pain and restoring mobility. And you wouldn't necessarily be considered too old for this operation!


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