Joint Replacements for the Foot and Ankle: Is It Possible?

Boomers in Western Pennsylvania are not backing down from foot and ankle arthritis. Surgical advances are keeping them active and pain-free.

They danced to the Beatles, the Rolling Stones, and disco. They worked out with Jane Fonda and made jogging their national pastime. Now approaching retirement, many members of the “Me Generation” aren’t ready to slow down, even if their bodies are. Baby boomers are more likely than previous generations to seek care when arthritis develops in their toes, feet, and ankles. “An ounce of prevention is worth a ton of cure,” says Dr. Evangelista, a fellowship-trained foot and ankle surgeon at Specialty Orthopaedics (www.specialtyorthopaedics.com) in Hermitage, PA. There are more than 100 different types of arthritis, including gout, rheumatoid arthritis, psoriasis, and lupus. According to the American College of Foot and Ankle Surgeons, the most common forms to affect the foot and ankle are post-traumatic arthritis and osteoarthritis. Dr. Evangelista says many boomers who seek treatment for arthritis assume they’ll be able to resume activities such as running or playing sports. Seeking treatment early can improve the odds of preventing irreversible joint damage. For many patients with early-stage foot or ankle arthritis, changes in shoes or advanced custom orthosis can make a huge difference. While there is no fountain of youth for arthritis, Dr. Evangelista says there are more medical options available to baby boomers than ever before.

Big toes: Baby boomers will most likely develop osteoarthritis in their big toe joint. During walking, the big toe absorbs forces equal to nearly twice a person’s body weight. It plays an important role in stooping and standing. Some boomers start to develop big toe stiffness, a condition called hallux limitus or hallux rigidus, in their forties. Better surgical procedures now offer improved pain relief and joint movement to boomers with early stage arthritis at the big toe. Patients with advanced and severe arthritis may need to have the joint fused or replaced. While stronger screws and hardware are helping fusions last longer and slashing recovery time, fusing the big toe joint hopes to relieve pain by restricting the big toe’s range of motion. A new generation of big toe joint replacements shows promise, and they are designed to maintain as much of the big toe’s normal range of motion as possible while relieving pain from arthritis.

Ankles: Ankles are another prime spot for arthritis. Ankles are more likely to develop post-traumatic arthritis than osteoarthritis. For many baby boomers, the trauma was an ankle fracture or a bad sprain that may have happened in their teens or twenties. Innovative new surgical techniques allow foot and ankle surgeons to transplant small plugs of cartilage from one part of the ankle to another in some patients, slowing joint deterioration. Moreover, total ankle replacement surgeries are now available, and they involve replacing the bone surfaces in the ankle with two metal parts separated by a piece of polyethylene (a medical grade plastic), which moves between both metal components. This polyethylene piece is called a Mobile Bearing, and it helps to maintain the normal motion of the ankle. Providing ankle motion allows boomers to perform their daily activities with more normal body motion and places less stress on the body as a whole.