Around a year ago I broke my right leg in a motorcycle accident and have since developed arthritis in the area of the injury. My doctor has prescribed medication but the pain is really getting me down. I am a man in my mid forties and have always been active and used to enjoy running. Can you please advise what other treatment options might be available to me so that I can get back to a more active lifestyle?
Mr Nick Harris, Consultant Orthopaedic Surgeon replies:
It is not uncommon following a tibial fracture to develop arthritis in either the knee or the ankle especially if the fracture involves either joint, or heals with angular or rotational deformity. Arthritis can initially be managed with anti-inflammatory medication, physiotherapy or joint injections.
Mechanical symptoms can often be treated arthroscopically where a camera is placed inside the joint. The surgery is performed as a daycase and patients are usually able to return to work within a week or two. Where the fracture has healed with significant deformity it is sometimes possible to undertake a corrective osteotomy of the tibia.
The next line of treatment to consider is either joint replacement surgery or a fusion. Knee replacement surgery is well established with high success rate at 15 years. Ankle replacement surgery is less predictable although 75-90% of patients can expect the ankle replacement to last 12-20 years. There is a wide range of opinion regarding the ideal age for performing total ankle replacement surgery. In the UK it tends to be reserved for patients over the age of 50-60 years. In younger patients the treatment of choice is an ankle fusion. Following a good ankle fusion patients rarely have a noticeable limp and are usually surprised by how much movement they still retain despite the fusion.