Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Ankle Arthritis: A Significant Source of Disability
The ankle joint — unlike the hip and knee which develop primary osteoarthritis most commonly — develops arthritis predominantly from prior trauma: ankle fractures, chronic ankle instability, and osteochondral lesions. Post-traumatic ankle arthritis accounts for approximately 70% of ankle arthritis cases. It is a significant source of disability that, when severe, can be more debilitating than hip or knee arthritis from a functional limitation standpoint.
Conservative Management: What Works
Non-surgical management forms the first line of treatment and provides meaningful relief for many patients with mild to moderate arthritis. Ankle-foot orthoses (AFOs) or stiff-soled boots with rocker bottom soles reduce joint motion and impact loading. Custom orthotics with accommodative modifications distribute pressure away from the most affected areas. Corticosteroid injections provide temporary anti-inflammatory relief — typically 3-6 months of meaningful benefit. Viscosupplementation (hyaluronic acid injection) is used by some practitioners. Activity modification, weight management, and anti-inflammatory medications support conservative care. Hydrotherapy and aquatic exercise maintains fitness with reduced joint impact.
Ankle Fusion (Arthrodesis)
Ankle fusion has been the gold standard surgical treatment for end-stage ankle arthritis for decades. The tibiotalar joint is fused in neutral position using internal fixation (screws and/or plates). Fusion eliminates the painful joint while preserving walking function — patients walk with a slightly stiff gait but typically report dramatic pain relief and functional improvement. Long-term outcomes are well-documented and generally excellent. The drawback is permanent loss of ankle motion and potential for adjacent joint arthritis development over 10-20 years.
Total Ankle Replacement
Modern total ankle replacement implants have significantly improved outcomes compared to earlier generations. Ankle replacement preserves motion, potentially protects adjacent joints from compensatory arthritis, and allows a more natural gait pattern than fusion. Indications include lower-demand patients (typically older and less active), specific anatomic patterns, and patients with adjacent joint arthritis that would be worsened by fusion. Younger, heavier, or more active patients typically have better long-term outcomes with fusion. The podiatric surgeons at Balance Foot & Ankle in Howell and Bloomfield Township perform both ankle fusion and replacement, with selection based on detailed patient-specific assessment.
Choosing Your Treatment Path
The right treatment depends on arthritis severity, patient age and activity level, body weight, adjacent joint status, bone quality, and patient preferences about trade-offs between motion preservation and reliability. Call (810) 206-1402 for an ankle arthritis evaluation and consultation to discuss your specific situation and realistic options.
Foot or Ankle Pain? We Can Help.
Balance Foot & Ankle — Howell & Bloomfield Township, MI
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Ankle Arthritis Slowing You Down? Explore Your Treatment Options
Ankle arthritis doesnt always mean surgery. Dr. Tom Biernacki offers a full range of conservative treatments including custom bracing, joint injections, physical therapy protocols, and regenerative options — with surgery reserved for when it truly is the best answer.
Learn About Ankle Arthritis Treatment | Book Your Appointment | Call (810) 206-1402
Clinical References
- Saltzman CL, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthopaedic Journal. 2005;25:44-46.
- Barg A, et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot and Ankle Clinics. 2013;18(3):411-426.
- Thomas RH, Daniels TR. Ankle arthritis: total ankle replacement versus arthrodesis. Clinics in Podiatric Medicine and Surgery. 2009;26(3):491-510.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentMore Podiatrist-Recommended Arthritis Essentials
Cushioned Running Shoe
Hoka Clifton 10 — max cushioning reduces joint impact for arthritic feet.
Wide Walking Shoe
- FuelCell foam delivers a propulsive feel to help drive you forward
- ENCAP midsole cushioning combines lightweight foam with a durable polyurethane rim to deliver all-day support
- Reflective accents designed to catch the light
- TPU back tab
- New Balance MADE contains a domestic value of 70% or more. MADE makes up a limited portion of New Balance’s US sales.
New Balance 990v6 — wide toe box accommodates arthritic first-MTP (hallux rigidus).
Orthotic Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
PowerStep Pinnacle — offloads the big toe joint during gait.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Foot and ankle arthritis progresses silently — cartilage doesn’t regrow, but joint fusion, cheilectomy, and biologic injections can restore function at every stage. Balance Foot & Ankle offers the full arthritis spectrum: bracing, injections, and reconstructive surgery. Start with a consult so we can image the joint and give you a realistic 5-year outlook.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
Frequently Asked Questions
Can a podiatrist treat arthritis in the foot?
How much does a podiatrist visit cost without insurance?
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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