Post-Traumatic Arthritis of the Foot and Ankle
Post-traumatic arthritis is a form of joint degeneration that develops after a previous injury, such as a fracture, dislocation, or severe ligament damage.
Post-traumatic arthritis (PTA) in the foot and ankle develops after an injury and can lead to chronic joint pain, stiffness, and deformity over time. Surgical treatment depends on the location and severity of the arthritis. Options include arthroplasty (joint replacement)—often performed at the first MTP joint or the ankle to preserve motion—and arthrodesis (fusion) of the midfoot, rearfoot, or ankle to relieve pain and stabilize the foot. In complex cases involving bone loss or significant deformity, custom 3D-printed implants may be used to rebuild damaged bone. These surgical approaches aim to reduce pain, restore function, and improve long-term mobility.
- Common in the foot and ankle, particularly at:
- Ankle joint
- Midfoot (Lisfranc and tarsometatarsal joints)
- Rearfoot (subtalar, talonavicular, and calcaneocuboid joints)
- First metatarsophalangeal joint (1st MTPJ)
- Trauma can disrupt cartilage or joint alignment, leading to inflammation, stiffness, pain, and gradual joint degeneration over months to years.
Take a listen below to hear from the experts at Thrive Reconstructive Surgery
What Are the Symptoms of Post-Traumatic Arthritis of the Foot and Ankle?
Chronic pain and stiffness, often worsened by activity
Swelling or tenderness over the affected joints
Loss of joint motion or deformity
Difficulty walking, running, or wearing normal shoes
Progressive disability and reduced quality of life
Surgical Treatment Options
Ankle Arthroplasty
- Total ankle replacement (TAR) is indicated for isolated end-stage ankle arthritis with preserved alignment and ligament integrity
- Components are typically made of titanium and polyethylene
- Modern three-component designs improve implant longevity
- Benefits: Motion preservation and reduced gait abnormalities compared with fusion
- Not ideal for patients with severe deformity or neuropathy
- Recovery Timeline
- Weeks 1-2: Skin checks
- Weeks 3-4: Non-weight-bearing; early bone consolidation; serial X-rays
- Weeks 5-6: Protected weight-bearing in a CAM boot; begin physical therapy
- Weeks 7-12: Gradual transition through weight-bearing protocol
1st MTPJ Arthroplasty
- Replaces the big toe joint when arthritis is severe and motion preservation is desired
- Options include:
- Hemi-arthroplasty (metal resurfacing)
- Total joint implants
- Benefits: Maintains joint motion and relieves pain
- Best suited for low-demand patients or those who require preserved dorsiflexion
- Recovery Timeline
- Weeks 1-2: Skin checks
- Weeks 3-4: Protected weight-bearing; early bone consolidation; serial X-rays; begin physical therapy
- Weeks 5-10: Gradual transition through weight-bearing protocol
3D-Printed Bone and Joint Replacements
- Used in complex reconstructions where large portions of bone are missing or severely deformed
- Ideal for patients with:
- Severe post-traumatic deformity
- Failed prior fusions or joint replacements
- Bone loss due to infection, tumor, or trauma
- Custom 3D-printed titanium implants can be designed to reconstruct:
- Talus (total talus replacement)
- Calcaneus
- Midfoot bones
- These implants are often combined with soft-tissue reconstruction or fusion techniques
- Recovery Timeline
- Specific to patient and implant
- Typically involves 6-8 weeks of offloading before gradual weight-bearing begins
Used when pain is severe, the joint is unstable, or motion-preserving options are not feasible.
Ankle Arthrodesis
- Fusion of the tibia to the talus
- Considered the gold standard for end-stage ankle arthritis
- Highly durable, especially for younger or high-demand patients
- Recovery Timeline
- Weeks 1-2: Skin checks
- Weeks 3-4: Non-weight-bearing; early bone consolidation; serial X-rays
- Weeks 6-8: Protected weight-bearing in a CAM boot; begin physical therapy
- Weeks 9-12: Gradual transition through weight-bearing protocol
Midfoot & Rearfoot Arthrodesis
- Commonly involves the Lisfranc, talonavicular, subtalar joints, or a full triple arthrodesis
- Indicated for collapse, instability, or post-traumatic arthritis (PTA) following injuries such as Lisfranc fracture-dislocation or calcaneal fractures
- Restores foot alignment and relieves pain
- Recovery Timeline
- Weeks 1-2: Skin checks
- Weeks 3-4: Non-weight-bearing; early bone consolidation; serial X-rays
- Weeks 6-8: Protected weight-bearing in a CAM boot; begin physical therapy
- Weeks 9-12: Gradual transition through weight-bearing protocol
