Find a Surgeon
Share on facebook
Facebook
Share on twitter
Twitter
Share on linkedin
LinkedIn
Share on email
Email

FAQ

Share on facebook
Share on twitter
Share on linkedin
Share on email

Rheumatoid Arthritis (RA) of the Foot and Ankle

INTRO
CAUSES
SYMPTOMS
DIAGNOSIS
TREATMENTS OPTIONS
COMPLICATIONS
ORTHOFIX SOLUTIONS

Rheumatoid Arthritis (RA) of the Foot and Ankle

Rheumatoid Arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease that can affect multiple joints in the body but more commonly affects the hands and feet. Foot and ankle symptoms related to RA are more prevalent in women than in men. 10 It occurs when the immune system attacks the synovium, which is the lining of the membranes surrounding the joints.11

Rheumatoid arthritis of the ankle

Causes

Causes are unknown. There may be a genetic reason, but some experts believe it could be an environmental “trigger” (such as a bacterial or a virus infection) to activate the pathology in patients who inherit RA.

Symptoms

Stiffness, swelling, severe pain and discomfort are the most common symptoms. They tend to come and go in cycles called “flares” and may last from a few days to several weeks, being worse in the morning and after inactivity. Often patients with RA experience other symptoms in their feet and ankles such as nodules in the Achilles tendon or lax tendons and ligaments in the middle foot that may cause collapsing of the arch. In addition to mobility issues, particularly with ramps and stairs, deformities may progress leading to difficulty wearing shoes. 11,12

RA involving the ankle causes inflammation around the joint, due to the friction between the ankle from the degenerated cartilage. The surrounding tissues that support the ankle may also be damaged, becoming weak and unable to firmly support the joint. The ankle joint structure may also be seriously affected over time, leading to permanent changes in the joint shape.

Besides inflammation symptoms, other signs may be fatigue, low-grade fever and weight loss.

Diagnosis

A doctor will diagnose RA of the ankle with a physical or clinical examination and imaging. The doctor will investigate the medical history of the patient, check the ankles for any sign of inflammation and test the range of motion.

Imaging, including an X-ray, ultrasound, and MRI scans, may be needed to assess the extent and exact location of the joint damage. Blood tests are also used to identify serologic factors associated with RA or an associated condition.

Treatment Options

Treating this condition may involve a combination of different procedures, which include non-surgical options such as orthotic devices, bracing, physiotherapy, ice/rest/offloading, an anti-inflammatory diet, quitting smoking, and medications to reduce inflammation and pain. For those patients who suffer from an advanced form of RA of the ankle, the recommended treatment option is surgery. 11 13

Based on the patient’s lifestyle, type of RA and extent of the cartilage damage, the surgical technique could be fusion (arthrodesis) of the two bones that form the joint to prevent them from rubbing and provoking inflammation and pain. In some cases, a total ankle replacement may be needed to minimize pain and discomfort in the ankle, improve stability and recover function.

Complications

Over time, RA can deform joints and cause them to shift out of place. RA may also affect many non-joint structures, including skin, lungs, kidneys, eyes, bone marrow, and blood vessels. Osteoporosis and infections are further complications.

Failure for the fusion to heal and increased stress on other joints following an ankle fusion are the most concerning post-surgical complications. 14

Ankle Hindfoot Nailing System™

Important safety information: Download the Product Instructions For Use.

The Orthofix Ankle Hindfoot Nailing System (AHN) is designed to be used for the fusing and fixation of bones in the ankle.

KNOW MORE
  1. Michelson J, Easley M, Wigley FM, Hellmann D. Foot and ankle problems in rheumatoid arthritis. Foot Ankle Int. 1994 Nov;15(11):608-13. doi: 10.1177/107110079401501106. PMID: 7849976
  2. Kandola, A. Carteron N (rev). 2018. How does rheumatoid arthritis affect the ankles? Medical News Today. www.medicalnewstoday.com
  3. American Academy of Orthopaedic Surgeons. Rheumatoid Arthritis of the Foot and Ankle. www.orthoinfo.aaos.org
  4. American College of Foot & Ankle Surgeons. Rheumatoid Arthritis in the Foot and Ankle. www.foothealthfacts.org
  5. The American Orthopaedic Foot & Ankle Society (AOFAS). Rheumatoid Arthritis of the Foot and Ankle. www.footcaremd.org
Logo Orthofix

ORTHOFIX SOLUTIONS

The Agile Nail is intended for insertion in the medullary canal of a femur for the alignment and the stabilization of fractures and for the correction of deformities. It is indicated for the treatment of subtrochanteric fractures and of femoral shaft fractures, in pediatric patients, with the exception of newborns and infants, and in adult patients with an appropriate medullary canal. The indications include:

  • Prophylactic nailing of impending pathologic fractures;
  • Fixation of femurs that have been surgically prepared (osteotomy);
  • Non-unions and malunions;
  • Reconstruction following tumor resection and grafting and bone lengthening and shortening.

The Orthofix Ankle Hindfoot Nailing (AHN) System is intended to facilitate tibiotalocalcaneal arthrodesis (fusion). Specific indications include:

  • Avascular necrosis of the talus
  • Failed total ankle arthroplasty
  • Trauma (malunited tibial pilon fracture)
  • Severe deformity or instability as a result of talipes equinovarus, cerebral vascular accident, paralysis or other neuromuscular disease
  • Revision ankle arthrodesis
  • Neuroarthropathy
  • Rheumatoid arthritis
  • Osteoarthritis
  • Pseudoarthrosis
  • Post-traumatic arthrosis
  • Previously infected arthrosis
  • Charcot foot
  • Severe endstage degenerative arthritis
  • Severe defects after tumor resection
  • Pantalar arthrodesis

INTENDED PURPOSE
The Guided Growth Plate Systems are plates intended to provide bone fixation.

INDICATIONS FOR USE
The Guided Growth Plate Systems are indicated for gradually correcting deformities of long bones in growing children. Specific acquired or congenital patterns of bone deformity for which the device will be indicated include:
• Valgus, varus or flexion, extension deformities of the knee (femur and/or tibia);
• Valgus, varus, or plantar flexion deformities of the ankle.

Fitbone is an intramedullary lengthening system for limb lengthening of the femur and tibia.

The G-Beam Fusion Beaming System is intended to be inserted in the bones of the foot and ankle for alignment, stabilization and fixation of various fractures and osteotomies, fusions and reconstructions. It is indicated for fracture and osteotomy fixation, reconstruction procedures, non-unions and fusions of bones of the foot and ankle including metatarsals, cuneiforms, cuboid, navicular, calcaneus and talus. Specific example: medial and lateral column fusions resulting from neuropathic osteoarthropathy (Charcot osteoarthropathy).

The JuniOrtho Plating System is indicated for internal fixation and stabilization of femoral and tibial fractures, osteotomies, mal-unions and non-unions. Indications include:

  • Varus, valgus, rotational and/or shortening osteotomies
  • Femoral neck and/or pertrochanteric fractures
  • Proximal and distal metaphyseal fractures
  • Pathological and impeding pathological fractures

Use of the JuniOrtho Plating System is indicated in pediatric (excluding newborns) and small stature adult patients.

Indications:

  • Short Stature
  • Bone loss
  • Open fractures​
  • Non-union
  • Angular deformities

Indications:

  • Metacarpal and metatarsal lengthening
  • Calcaneal lengthening
  • Pediatric forearm lengthening
  • Metacarpal, metatarsal and phalangeal lengthening
  • Joint arthrodesis
  • Joint stiffness; Comminuted intra-articular fractures
  • Soft tissue correction in patients with neurological disorders (e.g. cerebral palsy)
  • Arthrodesis of the 1st carpo-metacarpal joint following soft tissue correction
  • Complex upper extremity deformities
  • Hand contractures
  • Wrist contractures
  • Indicated for pediatrics through adult

INTENDED PURPOSE

The SOLE™ Medial Column Fusion Plate (SOLE MCF) is intended to provide bone fixation.

INDICATIONS FOR USE

The SOLE MCF is indicated for orthopedic applications within the anatomical area of the foot and ankle, including but not limited to the medial column (consisting of the first metatarsal, medial cuneiform, navicular and talus). Specific indicated procedures include:

  • Arthrodesis
  • Joint depression stabilization
  • Fracture and/or osteotomy fixation
  • Reconstruction
  • Revision

to be performed for conditions such as Charcot neuroarthropathy.

The TL-HEX system is intended for limb lengthening by metaphyseal or epiphyseal distractions, fixation of open and closed fractures, treatment of non-union or pseudoarthrosis of long bones and correction of bony or soft tissue defects or deformities.

INDICATIONS:

  • Fractures
  • Non-unions/ malunions
  • Limb lengthening
  • Deformity corrections
  • For pediatrics, the same indications apply provided a growth plate is not compromised

“www.limbhealing.com”
This website is for educational purposes only and is not a substitute for a consultation with your physician or health care professional. The information provided herein is a service and should be viewed only as opinion. The information contained herein has been obtained from sources deemed ethical and reliable, but completeness is not guaranteed.

ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ABOUT DIAGNOSIS AND TREATMENT INFORMATION.

This site is intended for U.S. patients and their caregivers.

CONTACT

ORTHOFIX MEDICAL INC.
3451 Plano Parkway
Lewisville, TX 75056
USA

Phone: 214.937.2000
Email: customerservice@orthofix.com

Full prescribing information can be found in product labeling.

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

© 2022 Orthofix Srl
Agile Nail™, Ankle Hindfoot Nailing System™, eight-Plate Guided Growth System™, eight-Plate Guided Growth System+™, Fitbone™, G-Beam™, JuniOrtho™ Plating System, LRS Advanced™, Minirail™, SOLE™ Medial Column Fusion Plate, TL-HEX TrueLok Hexapod System™ are trademarks or registered trademarks of Orthofix S.r.l. TrueLok is a trademark or registered trademark exclusively licensed to Orthofix Medical Inc., and its affiliate companies. The relevant short forms, as indicated in brackets next to each registered trademark, are also used alone as distinctive signs in the name and on behalf of Orthofix S.r.l. and are protected in accordance with the provisions set by the local Intellectual Property law.