The Center for Podiatric Care and Sports Medicine

Maintaining Mobility: More Middle-Aged Joggers Will Mean an Increase in Ankle Surgeries

Posted by on Wednesday, April 23rd, 2014


Knee and hip replacements tend to garner much of the attention in the world of orthopedic surgery, but we’re predicting a marked increase in the number of ankle surgeries performed each year, as more boomers age while still trying to remain active. The American Academy of Orthopedic Surgeons estimates there may be as many as 25,000 ankle replacements in 2014.

Similarly, the National Health Service of England estimates there will be “tens of thousands of operations” necessary in the coming years — up from just 1,000 ankle replacements done last year. They are citing the trend in middle-age joggers, tennis players, and footballers for the dramatic shift in the number of ankle surgeries.

joint pain
Getting older naturally takes its toll on the joints, no matter how physically fit you are.
Image Source: Flickr user: PeterM7

Why Do People Need Ankle Surgeries?

Ankle replacement surgery is done on people who are suffering from severe ankle arthritis. In the UK, 30,000 people are diagnosed with ankle arthritis, specifically. In America, the CDC reports that one in five adults have some form of doctor-diagnosed arthritis.

The cause of arthritis depends upon the type a person has:

Osteoarthritis is a “wear and tear” form of the disease. As we age, the smooth cartilage connecting our joints wears away, causing bone-on-bone contact, inflammation, pain, and stiffness. Other risk factors include obesity and genetics.

Rheumatoid arthritis is a systemic inflammatory disease where the immune system attacks and destroys the body’s cartilage. The exact triggers of RA are unknown, but it’s believed to be caused by a combination of genetics and environmental factors that activate these genes.

– Post-traumatic arthritis occurs following an injury. Most commonly, we see this type of arthritis following a fracture, dislocation, severe sprain, or ligament injury. Following an injury, the body unleashes hormones that stimulate cartilage death.  In fact, injured joints are seven times more likely to become arthritic, regardless of the treatment, and people who did not seek proper treatment are even more susceptible.

types of arthritis
Joint problems increase with age.
Image Source:

Why Are Active Boomers at Risk for Arthritis?

“Repeated activity can cause a lot of stretch of the ankle ligaments, so the stability of the ankle is reduced over time,” Orthopedic surgeon and professor Tony Kochhar of London Bridge Hospital explains. “Then you become more likely to roll the ankle — and that’s when you start to aggravate it more and more.”

He adds that people who decide to take up a new sport at age 40 and beyond have not developed the thickened, protective ligaments necessary to prevent injury. Many older athletes tend to overestimate their physical fitness. Yet, even people who are truly in “good shape” have to understand that tissues simply do not heal as quickly in one’s forties, fifties, sixties, and seventies.

What Are the Treatment Options for Arthritis?

Conservative treatments for ankle arthritis include:

– Over-the-counter anti-inflammatory medication

– Shoe orthotics and custom footwear

– Steroid and synovial fluid injections

– Ankle braces

– Canes

– Weight loss

– Strength training

– Physical therapy

Often we recommend these therapies for younger patients or individuals with milder stages of cartilage degeneration. The NY Times reports that a third of patients do not find relief from surgery, so it’s important to try these home remedies for arthritis before progressing to more invasive treatment options.

ankle arthritis treatment
Choosing treatment: Ankle fusion limits range of motion, but ankle replacements aren’t designed to last forever either.
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Up until recently, the most common surgical intervention was a joint fusion. With this procedure, rods fuse the ankle bones together and prevent them from grinding against one another. The great thing about an ankle fusion is that pain is eliminated. The downside is that it changes a person’s gait pattern, which can lead to knee and hip problems. Patients also suffer from limited mobility.

Nowadays, most people elect to have an ankle replacement done. With a replacement, an artificial prosthesis is implanted to prevent bone-on-bone rubbing. Patients still need physical therapy to “learn how to walk again.” Yet, the range of motion is far superior. Since ankle replacement technology is still relatively new, some surgeons question the resilience of implants 20 years down the line.

New York City Arthritis Treatment

Arthritis pain is something that individuals should not have to suffer. The Center for Podiatric Center and Sports Medicine offers two treatment facilities —  one in Manhattan and one in Westchester — where you can meet with physical therapists, sports doctors and podiatrists to get top-level care for your arthritic joints. We will work with you in determining the best course of treatment for your needs, and a healthy exercise routine to help you maintain mobility and protect your joints. Book an appointment online today!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.