Stages of Ankle Arthritis

Updated 9/18/2018

While ankle arthritis is difficult for some to diagnose, UFAI's physicians are nationally known for their diagnostics and treatment plans. This especially holds true for those requiring complex treatment.


Our personalized approach to care, decades of experience and research allows us to customize the very best treatment for each patient.

Our goal is to retain mobility in the joint and provide long-term pain relief using the least invasive and most effective protocols available.

Early Stage Ankle Arthritis

In a healthy ankle, layers of rubbery, flexible cartilage cover the joints to protect them from the friction of movement. Synovial fluid – a white, viscous fluid found in joint cavities – helps to lubricate the joint, making ankle motion pain-free under normal circumstances.

Early stages of Ankle arthritis, University Foot and Ankle Institute
You may feel pain, swelling and stiffness in the joint.


In the early stages of ankle arthritis, synovial fluid is still aiding joint motion, but the cartilage begins to wear thin and bone spurs will start to form. Your ankle joints may start to feel uncomfortable, especially when they’ve been overused, such as after a long day of walking.


They may also feel stiff after sitting for a stretch of several hours. However, many people ignore this discomfort early on, chalking the stiffness and pain up to old age.


Treatment Options for Early Stage Ankle Arthritis:

  • Wear supportive footwear with plenty of cushioning.
  • You may take NSAIDs (non-steroidal anti-inflammatory drugs) for pain, like ibuprofen or naproxen.
  • Keeping active can help keep your joints healthy, especially in the early stages.
  • Avoid overuse by adopting a low-impact activity, like cycling or swimming.
  • If you’re overweight, try to lose some weight. For every pound lost, you can take four pounds of pressure off your ankles.
  • Custom orthotics can minimize pressure on the foot and help alleviate pain.
  • Regenerative therapies, like stem cell therapy and platelet-rich plasma therapy, can boost your body’s ability to heal itself and regenerate new cartilage tissue.
  • Arthroscopic joint clean-up is a procedure that can help mitigate spurs, scarring, and mild damage to the cartilage.


Ankle arthritis is a progressive degenerative disease. Getting treatment quickly can help preserve joint function and prevent permanent damage.


Mid-Stage Ankle Arthritis

PRP for ankle arthritis, University Foot and Ankle institute
Platelet rich plasma (PRP) can regenerate new cartilage tissue.

At the mid-stage, the symptoms of ankle osteoarthritis grow much more noticeable and difficult to ignore. The joint pain typically worsens throughout the day, and the ankle may unexpectedly catch or give way without warning. Running and even walking or standing for a period of time could cause extreme pain, while stiffness will likely occur upon getting out of bed in the morning.


In this stage, the cartilage continues to wear down and the space between the bones narrows. As a result, the bones thicken and bone spurs develop along the joint. The joints may begin to swell, especially after activity.


While it may be tempting to rest the joints, it’s important to stay active. Muscles weakened due to atrophy cannot support the joint as well, which could contribute to the joint damage and increase your risk of injury.


Treatment Options for Mid-Stage Ankle Arthritis:

  • Continue to take NSAIDs to reduce the inflammation and manage pain and swelling.
  • Daily low-impact exercise will stave off arthritic degeneration.
  • Regenerative therapies: stem cell therapy or platelet-rich plasma injected into the ankle joint can rejuvenate tissue
  • Arthroscopic spur removal and joint clean-up
  • Denovo cartilage repair utilizing tissue from a young donor
  • Ankle replacement or ankle fusion


Late Stage Ankle Arthritis

In the late stage of ankle arthritis, the cartilage is nearly completely destroyed and there is very little space between the bones to allow for motion. The joint will be stiff, and in some cases, totally immobile. The normally-lubricating synovial fluids are lost, increasing friction and damaging bones during movement.


The joint cavities fill with inflammatory fluids in their place, stretching the joint capsule and causing more pain, stiffness, and swelling. Walking or moving the ankle joint causes extreme pain.


At this stage, conservative treatment may not be an option. While your doctor can prescribe stronger pain medication, the ankle will probably need to undergo some sort of treatment, such as:

  • Stem cell and platelet-rich plasma therapy. However, these options may not be as effective as the arthritis advances.
  • Arthroscopic joint clean-up. This also may not be as effective as the arthritis advances.
  • Ankle fusion. Fusing the ankle joint immobilizes the ankle, which will greatly reduce pain, but limit ankle function.
  • Ankle replacement. Surgery to replace the joint to reduce pain and restore function.
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