Ankle arthritis: what is subtalar arthritis?

The subtalar joint, located below the ankle between the talus bone and the calcaneus bone, is the primary joint of the foot. Along with the knee, the subtalar joint plays a fundamental role in the dampening of body weight, providing support and absorbing impact when walking, running or jumping.

What causes arthritis in the foot?

The most common cause of subtalar osteoarthritis is a traumatic injury, either by repetitive microtrauma or by a fracture of the calcaneus or the talus. The posterior part of the joint (posterior subtalar) is the most frequently affected.

Other causes are autoimmune diseases such as rheumatoid arthritis, infections, and scars of calcaneal fractures, uncorrected congenital deformities of the position of the talus or calcaneus, or dysfunction of the posterior tibial tendon.

Symptoms of subtalar arthritis

Patients with arthritis in the foot will often pain, swelling and stiffness in the back of the foot and in the lateral and posterior areas of the ankle. These symptoms are often stronger in the morning, but also when walking on uneven ground, running or playing sports.

Treatment of subtalar arthritis

The goal of treatment is to limit painful joint movement, to correct misalignment, and to relieve pressure points.

Some of the recommended treatments include:

• Perform physical therapy and non-impact exercises such as swimming or cycling (these help mobility, proprioception and strength)
• Modify physical activity avoiding activities that cause pain.
• Non-steroidal analgesic or anti-inflammatory drugs.
• Modification of footwear, use of orthopaedic devices or correctors customised to stabilise the joint and also, the middle tarsal joint.
• Cartilage protectors, intra-articular infusions of hyaluronic acid, platelet-rich plasma, or conditioned autologous serum may help in the early stages.

Surgical treatment of subtalar arthritis

Surgical treatment is used when the patient's pain is incapacitating and prevents them from leading a normal life.

The operation involves a fusion or arthrodesis of the joint, specific in cases of arthritis, instability or deformity of the joint, which has not improved with non-invasive treatment.

Usually the patient retains some mobility, but it can be painful. That is why, by eliminating this mobility, the pain is also eliminated and the function of the rest of the joints of the ankle and of the foot is improved.