If your ankle has become stiff, swollen, or painful when you walk, you may be living with ankle arthritis. It is a common cause of long-term ankle pain, and it tends to worsen gradually over time. Effective ankle arthritis treatment is available in London, ranging from simple non-surgical care to ankle fusion and total ankle replacement.
Mr Francesc Malagelada is a Consultant Trauma and Orthopaedic Surgeon with a PhD in foot and ankle surgery. He will assess your ankle, explain what is causing your symptoms, and recommend the least invasive option likely to relieve your pain. Surgery is only ever suggested when it is genuinely the right choice for you.
Understanding Ankle Arthritis
Ankle arthritis means the smooth cartilage that lines your ankle joint has worn away. As the cushioning is lost, the bones rub together, which leads to pain, stiffness, and swelling. Over time, the joint can become harder to move.
Unlike the hip or knee, most ankle arthritis follows an earlier injury, such as a fracture or repeated sprains. This is known as post-traumatic arthritis, and it accounts for a large share of cases. The three main types are osteoarthritis (age-related wear), post-traumatic arthritis (after injury), and rheumatoid arthritis (an inflammatory condition).
Symptom checklist
Symptoms tend to build up slowly. Tick anything that applies to you. The more that apply, and the longer they have lasted, the more worthwhile a specialist assessment becomes.
If three or more of these sound familiar, a specialist assessment is worthwhile. The earlier ankle arthritis is diagnosed, the more treatment options are available to you.
There is no single best operation for everyone. The right choice depends on your age, activity level, bone quality, and the condition of nearby joints. The table below sums up the main differences.
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Feature
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Ankle fusion
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Ankle replacement
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|---|---|---|
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Joint movement
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Removed, the ankle is stiffened
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Kept, for a more natural feel
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Pain relief
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Durable and long-lasting
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Good and effective
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Best suited to
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Younger or active patients, or weaker bone
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Older or lower-impact patients
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Main trade-off
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The ankle no longer bends up and down
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May wear and need revision later
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Understanding Ankle Arthritis
Most people do not need surgery straight away. The right plan depends on how advanced the arthritis is, your pain levels, your age, and how active you want to be. We always start with the least invasive option that is likely to help.
For mild to moderate arthritis, simple measures can ease symptoms and may delay or avoid surgery. Exercise, weight management where relevant, and pain relief form the foundation of osteoarthritis care. Options include:
If pain flares, a targeted injection into the joint may settle inflammation for a period of weeks to months. This can buy time and help you stay active while you consider longer-term options. Ultrasound guidance is used for accurate, comfortable placement. Injections do not cure arthritis, but they can be a useful part of your plan.
Ankle fusion joins the worn bones of the ankle so they grow together into one solid unit. Removing the damaged joint surfaces stops the painful bone-on-bone movement. Where suitable, this can be done with keyhole (arthroscopic) techniques, which may reduce scarring and speed up healing.
Fusion gives durable, long-lasting pain relief and is often chosen for younger or very active patients, or where the surrounding bone is weak. The trade-off is that the ankle itself no longer bends up and down, although nearby joints take over much of the movement, so many people walk well afterwards.
A total ankle replacement removes the damaged joint and replaces it with artificial parts, much like a hip or knee replacement. The main advantage is that it keeps movement in the ankle, which can feel more natural when you walk. NICE supports total ankle replacement as an option for selected patients with end-stage arthritis.
Replacements are often suited to older or less high-impact patients. Modern implants can last many years, though they may eventually wear and need revision. Your consultant will assess whether your bone quality, alignment, and activity level make you a good candidate.
Recovery from ankle surgery takes time and patience. After fusion or replacement, you will usually be in a cast or boot and will need crutches for several weeks while the area heals. Many people return to lighter activities within a few months, though full recovery can take up to a year. Your exact timeline depends on the procedure, your general health, and how closely you follow your rehabilitation plan. Physiotherapy is an important part of getting the best result. Your consultant and the wider team will guide you at every stage.
Testimonials
Real patients. Real outcomes. Verified independently on Doctify.
LMS, PhD. Consultant Trauma and Orthopaedic Surgeon. Foot and Ankle.
Consultant at The Royal London
Board member, GRECMIP
Honorary Senior Lecturer
Mr Francesc Malagelada is a fellowship-trained Consultant Trauma and Orthopaedic Surgeon who treats foot and ankle conditions exclusively. He has practised as a consultant at The Royal London since 2017 and is an Honorary Senior Lecturer at Queen Mary University of London. He is a board member of GRECMIP, the international group for minimally invasive foot and ankle surgery, holds a BOFAS-accredited foot and ankle fellowship, and has published widely in peer-reviewed journals. You can book an appointment for an assessment at short notice across four central London clinic locations.
Most people use a boot or cast and crutches for several weeks, then build up activity over the following months. Full recovery can take up to a year. Your consultant will give you a timeline based on your procedure and progress.
Although a fused ankle no longer bends up and down, nearby joints take over much of the movement. Many people walk comfortably and return to everyday activities. Your gait will be assessed as part of your follow-up care.
There is no single right answer. Fusion is often chosen for younger, more active patients, while replacement may suit older or lower-impact patients who want to keep ankle movement. Your consultant will assess your bone quality, alignment, and goals before recommending an option.
No. You can book a private consultation directly, without a referral from a General Practitioner (GP), with appointments often available at short notice. If you have private health insurance, your insurer may ask for a GP referral for cover, so it is worth checking with them.
Ankle fusion and replacement are recognised by all major UK health insurers. Cover varies by policy, so please confirm the details and any pre-authorisation requirements with your provider before treatment.
Modern ankle implants can last many years for most people. Like any joint replacement, they may eventually wear and need revision surgery. Your consultant will talk you through the likely lifespan based on your age and activity level.
Still have questions?
Send your enquiry through, and a member of Mr Malagelada's team will reply within one working day.
If ankle pain is holding you back, an early assessment gives you the most options. Mr Malagelada will explain what is happening in your ankle and set out a clear, personalised plan to arrange your appointment, in person or by video.
