Your contact partners
in this area:
Prof. <br /> Dr. med. habil.<br /> Georg Matziolis
Dr. med. habil.
Georg Matziolis

Senior Consultant of the Clinic for Orthopaedics and Accident Surgery

Acting holder of the Chair for Orthopaedics of the FSU Jena at the Waldkrankenhaus Eisenberg

036691 8-1002

Specialist Registrar Dr. med. Andreas Wagner
Specialist Registrar Dr. med. Andreas Wagner

Head of department hand and foot surgery

Specialist for Orthopaedics and Accident Surgery, Rheumatology, Hand Surgery, Special Orthopaedic Surgery, Physical Therapy and Chirotherapy.

Wear symptoms (arthrosis) on the upper ankle joint

The upper ankle joint is a joint which is subjected to heavy loads and has to bear many times the weight of the body when walking and taking part in sports. Injuries of the joint, for example frequent spraining, later result in changes in cartilage due to wear. Inflammatory changes to joints (for example rheumatoid arthritis) or metabolic disorders may also lead to joint wear.

Joint wear (arthrosis) often develops very gradually over several years: Occasional pain when climbing steps or walking on uneven ground develops into permanent pain with restriction of movement. The ability to drive a car can also be affected.

Conservative measures at an early stage consist of specific physiotherapeutic measures, joint injections and changes in footwear (shoes with soft soles, sole stiffening with tarsal roller). If these treatments do not lead to the required alleviation of the complaint, various operative treatment options can be considered, depending on the stage of the disorder.

If it is localised cartilage damage, the formation of replacement cartilage can be stimulated with an arthroscopic joint operation. Transplantation of cartilage-bone segments or implantation of patient-specific cultured cartilage cells is possible.

If the cause of the joint wear lies in an axial malpositioning of the lower leg or of the hindfoot (usually after bone fractures), in suitable cases a correction of the bone position can be carried out so that the ankle joint is loaded on the correct axis again. 

In advanced stages, the joint can no longer be preserved due to the cartilage wear. Here, either artificial joint replacement or stiffening of the upper ankle joint is possible. Both methods have their specific advantages and disadvantages, so that the decision in favour of one of the two procedures must be discussed with the patient.

In the case of stiffening, the lower leg is joined to the hindfoot so that rolling of the foot when walking is then hindered. However, the adjacent joints partially assume this function, so that the gait pattern is not obviously changed. After the operation, the foot must be immobilised for several weeks in a lower leg bandage or a special shoe (six to eight weeks). Then the sole of the ready-made shoe is changed in order to improve the gait pattern.

After implantation of an artificial joint, movement exercises begin immediately after the operation. After healing of the wound is completed (approx. 14 days), full weight can be placed on the foot in a special shoe. It is only possible to switch to the ready-made shoe after four to six weeks.

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