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Ankle Distraction

What is Ankle Arthritis?


Ankle Joint

Ankle arthritis is a term that describes a breakdown in the joint cartilage and damage to the surrounding subchondral bone. There are many well known treatments for ankle arthritis ranging from medication, to injections, to joint replacement and fusion surgery.


However, there is a joint preserving surgical alternative which harnesses the body’s healing potential to re-grow cartilage greatly reducing pain. This operation is called Ankle Distraction Arthroplasty and has become a viable treatment for ankle arthritis.

What Causes Ankle Arthritis?

Most ankle arthritis is caused by trauma to the joint. Many times the articular cartilage is damaged by a fracture of the ankle, tibia, or talus and wears out over time creating pain. Patients may have plates and screws around the ankle from the old injury. 


Other patients report having multiple ankle sprains which shear the cartilage leading to arthritis. Ankle 
arthritis does not typically develop as we age without these underlying injuries. 

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Post Traumatic Arthritic Ankle Joint

Symptoms Of Ankle Arthritis

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Distraction Allows New Cartilage To Grow

Ankle arthritis creates pain around the ankle that is worse first thing in the morning and loosens up throughout the day. The pain returns at the end of the day usually accompanied by stiffness.


Over time people with ankle arthritis will reduce their activity level to avoid pain. Some patients notice uneven shoe wear from walking on the side of the foot. 

Treating Ankle Arthritis

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Ankle distraction arthroplasty is a regenerative, joint preservation surgery that optimizes the body’s natural ability to heal itself. Joint Distraction is a great alternative to joint replacement and fusion. By directing this healing response, we are able to regrow cartilage and improve mobility, but the best part is an increase in activity level with minimal pain.


Ankle distraction uses a temporary external fixator to create a no stress environment for the ankle joint. This facilitates tissue regeneration and remodeling of the cystic and hardened subchondral bone. Patients wear the external frame for a three month course after which the device is removed under anesthesia. Patients are encouraged to walk and can get the leg wet including showering and pools. 

Boris' Battle With Ankle Arthritis

Dr. Fragomen's patient, Boris, speaks about his experience with ankle distraction and tibia deformity



Once the frame is removed, patients have no restrictions on activity or weight bearing. Pain reduction starts immediately while further cartilage remodeling is ongoing. After one year patients see a sharp decrease in pain which continues to improve for an average of 3 years. After three years the improvement stabilizes and is enjoyed for over 10 years in 67% of patients. When the benefits of ankle distraction wear off, patients are able to choose from all treatments including repeat distraction, ankle fusion, or ankle replacement.

Medical Questions

Medical Questions

Dr. Fragomen:

Erica Lenihan, RN:

Zac Edelman, PA:

Eric Lau, PA:

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