Ankle Arthritis Treatment

Mr Billy Jowett | Consultant Orthopaedic Surgeon

Expert Ankle Replacement & Fusion Surgery in Southampton, Portsmouth & Chichester

Expert Ankle Replacement and Fusion Surgery

Ankle arthritis can be debilitating, limiting your mobility and causing persistent pain that affects your quality of life. As a consultant orthopaedic surgeon specialising in foot and ankle conditions, I offer advanced surgical solutions including ankle replacement and ankle fusion surgery across Southampton, Portsmouth, and Chichester.

With over many years of experience performing complex ankle procedures, including ankle joint replacement surgery, I help patients regain mobility and return to the activities they love.

Understanding Ankle Arthritis

Ankle arthritis occurs when the cartilage that cushions the ankle joint gradually wears away, leading to bone-on-bone contact. This causes ankle pain, stiffness, and reduced mobility that can significantly impact your daily life.

Unlike hip or knee arthritis which often develops due to age-related wear and tear, ankle osteoarthritis is most commonly caused by previous injury. A fracture, severe sprain, or repetitive ankle injuries can damage the cartilage and lead to post-traumatic arthritis years later. Other causes include inflammatory conditions like rheumatoid arthritis, though in some cases ankle arthritis develops without an obvious trigger.

As the condition progresses, the protective cartilage continues to deteriorate. The ankle joint may become deformed, and bone spurs can develop. Walking becomes increasingly difficult and painful, affecting everything from your ability to work to simple daily activities like shopping or climbing stairs.

Common Symptoms of Ankle Arthritis

You may be experiencing ankle arthritis if you have:

  • Persistent pain in your ankle, especially when walking or bearing weight
  • Stiffness and reduced range of motion, particularly in the morning or after rest
  • Swelling around the ankle joint that doesn’t improve
  • Difficulty walking on uneven surfaces or climbing stairs
  • A grinding or clicking sensation in the ankle
  • Pain that limits your daily activities and quality of life
  • Visible deformity or changes in how your ankle looks

When Conservative Treatment Isn’t Enough

In the early stages of ankle arthritis, non-surgical treatments can provide meaningful relief. These include:

  • Pain medication and anti-inflammatories to manage symptoms
  • Physiotherapy to maintain strength and range of motion
  • Orthotics and bracing to support the ankle and reduce stress on the joint
  • Lifestyle modifications such as weight management and activity adjustment
  • Steroid or hyaluronic acid injections to temporarily reduce inflammation and pain

However, as severe ankle arthritis progresses, these conservative measures often become less effective. If you’re finding that pain medications barely touch your discomfort, if injections only provide temporary relief, or if your quality of life is significantly impaired despite trying these approaches, it may be time to consider surgical treatment.

Your Surgical Treatment Options: Ankle Replacement vs Ankle Fusion

When ankle arthritis becomes severe enough to require surgery, I offer two proven surgical solutions. The right choice depends on your individual circumstances, activity level, and treatment goals.

Ankle Replacement Surgery (Total Ankle Arthroplasty)

Ankle replacement surgery involves removing the damaged ankle joint surfaces and replacing them with metal and plastic components that replicate natural ankle movement.

  • Patients with end-stage ankle arthritis affecting quality of life
  • Those who want to maintain ankle movement
  • Individuals with arthritis in both ankles
  • Patients who have already had a fusion in the adjacent joints

  • Preserves ankle motion and natural gait
  • Faster initial recovery compared to fusion
  • Reduced stress on surrounding joints
  • Better cosmetic outcome with minimal scarring

  • 2 weeks: Non-weight bearing in a cast
  • 6 weeks: Gradual return to weight-bearing
  • 3-4 months: Return to most normal activities
  • 6-12 months: Full recovery and return to impact activities

Modern ankle replacements have a 90-95% satisfaction rate, with implants lasting 10-15 years or longer in most patients.

Private ankle replacement surgery typically ranges from £12,000-£15,000, depending on individual requirements. This includes consultant fees, hospital charges, anaesthetist fees, and initial follow-up appointments.

What Our Patients Say

Needs new testimonial here

“I suffered for a long time in a lot of pain with a bunion and a shortening of ligaments in another toe. Mr Jowett operated on both of these and I am no longer in pain and back on the golf course pain free.”

Verified patient, Spire Southampton Hospital

Ankle Fusion Surgery (Ankle Arthrodesis)

Ankle fusion involves removing the damaged cartilage and fusing the ankle bones together, creating a solid, pain-free joint. While this eliminates ankle movement, it provides excellent pain relief and stability.

  • Patients with severe ankle deformity
  • Those with significant bone loss
  • Young, active individuals who place high demands on the ankle
  • Patients who have had failed previous ankle surgery
  • Those with poor bone quality where replacement may not be reliable

  • Highly reliable long-term solution
  • Excellent pain relief
  • No concerns about implant wear or failure
  • Suitable for heavy manual work and high-impact activities

  • 6 weeks: Non-weight bearing in a cast or boot
  • 12 weeks: Gradual return to normal activities
  • 4-6 months: Full recovery and return to demanding activities
  • Bone fusion typically complete by 3-4 months

Ankle fusion has a 90-95% fusion rate with excellent long-term pain relief in the vast majority of patients.

Private ankle fusion surgery typically ranges from £10,000-£13,000, depending on the complexity of your case.

Patient Experience: Richard’s Recovery Story

“Before my surgery with Mr Billy Jowett, I was really struggling with mobility. Walking any distance had become difficult and uncomfortable, and I relied on a stick to get around. Over time, my ankle arthritis had gradually worsened, affecting how I walked and limiting my day-to-day life more than I realised.

When I met Mr Jowett, he explained my options clearly and honestly, including the differences between ankle fusion and ankle replacement. I felt well informed and confident in the decision we made together. Everything he explained beforehand turned out to be exactly how things went.

The surgery and recovery were far more straightforward than I had expected. I spent a short time in a protective boot, followed by crutches and physiotherapy, and I was supported throughout with clear guidance and recommendations, including being referred to an excellent local physiotherapist. Pain was minimal and very well controlled, and overall I found the recovery process much easier than I’d anticipated.

I was able to return to work in a managed way and gradually get back to driving and seeing clients. I’m self-employed and often spend long days travelling, so being able to do this comfortably again has made a huge difference. I’m now back in the gym, working with a personal trainer, rebuilding strength and confidence in my leg.

The improvement compared to before surgery is significant. I’m walking faster, more comfortably, and with far less limitation. My quality of life is noticeably better, and I’m certainly glad I went ahead with the operation.

For anyone who is unsure or on the fence about having this kind of surgery, my advice would be simple: life is too short to spend it hobbling around in pain. It’s not going to get easier on its own – getting it sorted sooner rather than later is absolutely worth it.

I’m very grateful to Mr Billy Jowett for his care, clarity, and expertise, and for helping me get back to a far more comfortable and active life.”

— Richard Baker

My Approach to Ankle Arthritis Treatment

Every patient’s ankle arthritis is different, which is why I take time to thoroughly assess your individual situation before recommending treatment. Your consultation will include:

Comprehensive assessment:

  • Detailed review of your symptoms and medical history
  • Physical examination of your ankle function and alignment
  • Analysis of X-rays and any previous imaging
  • Discussion of your activity goals and lifestyle needs

Personalised treatment planning: I’ll explain both ankle replacement and fusion options in detail, discussing the pros and cons of each approach specifically for your situation. Many factors influence the decision, including your age, activity level, bone quality, degree of deformity, and whether you have arthritis in other joints.

Shared decision-making: I believe in partnering with my patients to make treatment decisions. You’ll leave your consultation with a clear understanding of your options and what to expect from each procedure.

Continuity of care: I personally perform your surgery and oversee your entire recovery, from pre-operative planning through rehabilitation and return to full function.

Insurance & Payment Options

I accept all major private medical insurance providers for ankle replacement and fusion surgery, including:

  • Bupa
  • AXA PPP Healthcare
  • Vitality Health Insurance
  • Aviva
  • Cigna
  • WPA

Self-pay options: If you’re funding treatment privately, I offer transparent pricing with no hidden costs. Payment plans may be available – please enquire during your consultation.

NHS patients: I also see NHS patients through my NHS practice. Please speak to your GP about referral options.

Locations: Serving Southampton, Portsmouth & Chichester

I conduct consultations and perform ankle replacement surgery and ankle fusion procedures at state-of-the-art facilities across the South Downs region:

Southampton: [Hospital name and address]

Portsmouth:[Hospital name and address]

Chichester: [Hospital name and address]

This geographic coverage ensures convenient access to specialist ankle arthritis treatment whether you’re based in Hampshire, West Sussex, or surrounding areas.

Frequently Asked Questions About Ankle Arthritis Surgery

The decision depends on several factors including your age, activity level, bone quality, and the severity of your arthritis. Generally, ankle replacement is preferred for patients who want to preserve motion and have good bone quality, while fusion is often better for younger, more active patients or those with significant deformity. During your consultation, I’ll assess your individual circumstances and discuss which option offers you the best long-term outcome.

The procedure typically takes 1.5-2 hours, performed under general anaesthetic. You’ll usually stay in hospital for 1-2 nights following surgery.

Most patients adapt very well to ankle fusion and walk with a near-normal gait. While you lose movement at the ankle joint itself, the surrounding joints compensate. Many patients report they can walk long distances without pain and return to activities including hiking, cycling, and even running.

Recovery follows a structured programme. You’ll be non-weight bearing for 2 weeks, then gradually progress to full weight-bearing over the following 4 weeks. Physiotherapy is essential to regain range of motion and strength. Most patients return to desk work within 6-8 weeks and to more active pursuits within 3-4 months.

Modern ankle replacements are designed to last 10-15 years or more. Advances in implant design and surgical technique have significantly improved longevity. Some patients’ implants last considerably longer, particularly if they maintain a healthy weight and avoid high-impact activities.

Yes, ankle fusion is a permanent solution. The bones are fused together and remain solid. However, this doesn’t mean you can’t have further treatment if needed – if problems develop in surrounding joints years later, these can often be addressed.

As with any surgery, there are risks including infection, blood clots, nerve damage, and wound healing problems. Specific to ankle replacement, there’s a small risk of implant loosening or wear over time. With ankle fusion, the main risk is non-union (failure of the bones to fuse), which occurs in approximately 5-10% of cases. I’ll discuss all risks in detail during your consultation.

Possibly. Treatment recommendations can vary between surgeons based on their experience and assessment. If you’ve been told you need fusion but are interested in replacement, I’m happy to provide a second opinion and discuss whether replacement might be suitable for you.

Ankle replacement typically costs £12,000-£15,000, while ankle fusion ranges from £10,000-£13,000. These costs cover the surgeon’s fees, hospital charges, anaesthetist, and initial follow-up. I provide detailed cost breakdowns during your consultation, and accept all major insurance providers.

This depends on your occupation. For desk-based work, many patients return within 6-8 weeks. For jobs requiring standing or manual labour, you may need 3-4 months. I’ll provide specific guidance based on your work demands during your consultation.

Ankle replacement preserves your natural ankle motion – you’ll retain the ability to point your foot up and down. Ankle fusion eliminates this movement, creating a solid joint. However, most patients with fusion find the other joints in their foot compensate well, allowing near-normal function for daily activities.

Yes, physiotherapy is crucial for optimal recovery from both ankle replacement and fusion. I work with experienced physiotherapists who specialise in ankle rehabilitation. Your physio programme will be tailored to your procedure and progress, helping you regain strength, motion (for replacement), and return to activities safely.

Yes, though we typically treat one ankle at a time, allowing full recovery before addressing the second ankle. However, if both ankles are severely affected, we can discuss the timeline that works best for you.

If an ankle replacement eventually wears out or loosens, options include revision ankle replacement (replacing the components) or converting to an ankle fusion. The best approach depends on bone quality and your circumstances at the time.

Modern pain management techniques mean post-operative pain is well controlled. You’ll have strong pain relief immediately after surgery, transitioning to oral medications. Most patients find pain is manageable and decreases significantly within the first few weeks.

Most patients can return to low-impact activities including walking, swimming, cycling, and golf. I generally advise against high-impact sports like running on hard surfaces or contact sports, as these can accelerate implant wear. However, many patients enjoy active lifestyles including hiking, travel, and recreational sports.

The most common causes include previous ankle injuries (fractures or severe sprains), inflammatory conditions like rheumatoid arthritis, and gradual wear and tear over time. Some patients develop ankle arthritis without an obvious cause.

Yes, ankle replacements contain metal components and will typically trigger airport security scanners. I provide a medical device card for you to show security staff.

I’ll provide detailed pre-operative instructions, but key preparations include stopping certain medications (if advised), arranging help at home for the first few weeks, and ensuring your home is set up for limited mobility. We’ll discuss everything in detail before your surgery date.

You won’t be able to drive while in a cast or boot, and you must be confident you can perform an emergency stop safely. For right ankle surgery, this typically means 8-12 weeks before driving. For left ankle surgery with an automatic car, you may drive sooner once out of the boot. Always check with your insurance company.

Both procedures have excellent outcomes. My ankle replacement patients report 90-95% satisfaction with significant pain relief and improved function. Ankle fusion achieves successful bone union in over 90% of cases with excellent long-term pain relief. I audit my outcomes regularly and am happy to discuss my personal results during consultation.

Next Steps: Book Your Ankle Arthritis Consultation

If ankle arthritis is limiting your life, don’t wait for the problem to worsen. Early specialist assessment ensures you understand all your options and can make an informed decision about treatment.

During your consultation, I’ll:

  • Conduct a thorough examination of your ankle
  • Review your imaging and medical history
  • Explain whether ankle replacement or fusion is more suitable for you
  • Discuss realistic expectations for recovery and outcomes
  • Answer all your questions about the procedure
  • Provide transparent cost information

I consult at convenient locations across Southampton, Portsmouth, and Chichester, making specialist ankle care accessible throughout the South Downs region.

Get in touch:

+44 (0) 7856 853175

office@sdfac.co.uk