Ankle Arthritis Treatment in Los Angeles

What Is Ankle Joint Arthritis?

Ankle joint arthritis occurs when the cartilage in the ankle joint wears down, leading to pain and limited mobility. Most cases are classified as osteoarthritis, which typically affects one ankle but can occur symmetrically in some individuals.

As ankle cartilage deteriorates, the bones begin to rub against the exposed surface with each step, creating a cycle of progressive damage. The joint space narrows, restricting movement and causing pain. Over time, the body responds by growing extra bone (bone spurs), further limiting motion and worsening joint deterioration. The result is a vicious cycle of inflammation, stiffness, and increasing disability. Without proper treatment, ankle arthritis can significantly impact mobility and quality of life.

At Foot and Ankle Specialty Group, we prioritize providing you with the best ankle arthritis treatment in Los Angeles so you can return to a pain-free lifestyle.

Signs and Symptoms of Ankle Joint Arthritis

The symptoms of ankle arthritis can typically include the following:

• Pain: Ranges from mild to severe, worsening with activity
• Stiffness: Limited range of motion and difficulty bending the ankle
• Swelling: Increases with activity and becomes more persistent over time
• Bone Spurs: Extra bone growth that further restricts movement
• Difficulty Walking: Pain worsens with weight-bearing activities
• Cracking or Popping Sounds: Joint noises when moving the ankle

Causes of Ankle Joint Arthritis

Ankle arthritis can develop due to various factors, including:

• Repetitive Stress: Athletes, ballet dancers, and manual laborers often experience micro-damage to the joint over time
• Biomechanical Deformities: Structural abnormalities that alter ankle movement, leading to chronic joint damage
• Injuries: Severe ankle sprains, multiple mild sprains, or fractures that involve the joint surface
• Post-Traumatic Arthritis: Cartilage damage resulting from poorly healed fractures or misaligned joints
• Chronic Gout: Recurring inflammation that leads to joint degradation

Diagnosing Ankle Joint Arthritis

Dr. David J. Soomekh, the best ankle joint arthritis doctor in Los Angeles, conducts a thorough evaluation to diagnose the condition. Diagnosis includes:

• Patient History and Symptoms: A discussion of pain, stiffness, and lifestyle impact
• Physical Examination: Hands-on analysis of foot and ankle mobility
• Digital X-Rays: Imaging to assess joint space, bone spurs, and overall joint health
• MRI or CT Scans: Used in select cases to evaluate cartilage and bone quality

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Ankle Joint Arthritis Treatment Options

Dr. Soomekh, known as the best podiatrist in Los Angeles, emphasizes early diagnosis and personalized treatment plans to help patients maintain mobility and minimize pain.

Conservative Treatment for Ankle Joint Arthritis

Joints have a limited blood supply, making self-repair difficult. Conservative treatments aim to accommodate ankle arthritis through appropriate footwear, such as high-top shoes with stiff soles. Stiff soles reduce joint movement, minimizing pain, while rocker-bottom shoes promote forward motion with less ankle movement. Avoiding activities that exacerbate pain can help reduce inflammation and slow joint wear. Ice, anti-inflammatories, and custom orthotics can also help manage symptoms and prevent further damage, particularly in cases involving biomechanical deformities.

Bracing and Custom Orthotics

Many patients benefit from simple accommodations like bracing or custom orthotics. These devices help control motion and reduce stress on the ankle joint, making them effective for mild arthritis cases. Ankle Foot Orthoses (AFOs) provide additional support, limiting motion to alleviate pain. Hinged braces allow some movement, while unhinged braces restrict it completely. Both are custom-made using plaster molds and fitted by Dr. Soomekh in the office.

Physical Therapy

Physical therapy is a key component of conservative treatment for low-grade arthritis. Properly performed range-of-motion exercises, combined with bracing, can help slow disease progression. Patients typically attend therapy sessions up to twice weekly for several weeks.

Injection Therapy

Corticosteroids

Steroid injections temporarily reduce inflammation and scar tissue but do not repair cartilage damage. Dr. Soomekh administers these injections with minimal discomfort using ultrasound guidance. While effective for pain relief, their use is limited due to potential tissue breakdown.

Joint Fluid Replacement (Sodium Hyaluronate Injections, Supartz)

Hyaluronic acid, a natural component of joint cartilage, can be injected to improve lubrication and reduce irritation. Some studies suggest mild cartilage regeneration. Most patients require multiple injections (two to six) spaced one to two weeks apart. This treatment is ideal for mild joint deterioration and is performed in the office with ultrasound guidance.

Platelet-Rich Plasma (PRP) and Stem Cell Therapy (Bone Marrow Aspirate - BMA)

Platelets facilitate healing, but chronic injuries often lack sufficient platelet activity. PRP injections increase platelet concentration in the affected area, enhancing repair.

Stem cells, found in bone marrow, can differentiate into cartilage cells. BMA is extracted from the heel bone under local anesthesia, processed, and combined with PRP before being injected into the joint. Patients wear a walking boot for two to three weeks, and some require additional injections. Dr. Soomekh performs this procedure in the office with ultrasound guidance for precision.

Surgical Treatment for Ankle Joint Arthritis

When arthritis becomes debilitating and conservative treatments fail, surgery may be necessary. Though surgery can seem intimidating, Dr. Soomekh prioritizes techniques that minimize post-operative pain. Mild cases focus on joint preservation and cartilage regeneration, while severe cases require pain elimination and mobility restoration.

Mild to Moderate Ankle Arthritis

Ankle Arthroscopy (Joint Clean-Out)

A minimally invasive procedure using two small incisions — one for a camera and the other for surgical instruments — to remove inflammation, scar tissue, and bone spurs. This procedure delays arthritis progression and promotes cartilage growth, offering the best outcomes when performed early.

Cartilage Grafting with Stem Cell Therapy

This advanced procedure replaces missing cartilage using a combination of bone marrow-derived stem cells and donated cartilage grafts (DeNovo®). The graft is secured in place and acts as a scaffold for new cartilage growth. Patients wear a cast and use crutches for up to six weeks.

Ankle Joint Cartilage Transplant (OATS)

OATS replaces damaged cartilage and bone with donor tissue. The affected bone is removed and replaced with a precisely matched donor graft. Multiple grafts are used for larger defects. The risk of rejection is minimal. Patients wear a cast and use crutches for up to six weeks.

Severe Ankle Joint Arthritis

Ankle Joint Fusion

Severe arthritis with extensive cartilage loss often requires joint fusion. This procedure eliminates joint movement, and therefore pain, while still allowing for normal walking. The ankle and leg bones (tibia, fibula, and talus) are fused using screws and bone grafts.