Who is Mr Shelain Patel?

Mr Shelain Patel (BSc, MBBS, DipSEM, FRCS) is a consultant orthopaedic surgeon who works exclusively on foot and ankle conditions in London and Stanmore. He is one of only four foot and ankle surgeons at the Royal National Orthopaedic Hospital, the UK's top rated orthopaedic institution.

What conditions does Mr Shelain Patel treat?

He treats the full range of foot and ankle disorders including ankle sprains, ligament damage and instability, ankle arthritis and cartilage injuries, Achilles tendon tears and pain, bunions and big toe arthritis, flat feet and tibialis posterior tendon dysfunction, plantar fasciitis and heel pain, Morton's neuroma, foot drop following nerve and spine injuries, congenital and complex acquired deformities, and trauma including osteochondral lesions.

What surgery does Mr Shelain Patel perform?

Procedures include bunion correction, ankle replacement, ankle fusion, keyhole ankle arthroscopy and microfracture, Broström-Gould ligament repair, Achilles tendon repair and Haglund excision, big toe replacement and fusion, Morton's neuroma excision, flat foot and cavus foot reconstruction, minimally invasive metatarsal osteotomy, and tibialis posterior tendon transfer for foot drop. Only about one in three consultations leads to a discussion of surgery.

Where does Mr Shelain Patel practise?

His private practice is in the Harley Street district of Central London at HCA Princess Grace Hospital and King Edward VII's Hospital, and in North London at Spire Bushey, Elstree Waterfront and RNOH Private Care in Stanmore. The consultation address is 30 Devonshire Street, London, W1G 6PU.

How do I book a consultation with Mr Shelain Patel?

Consultations can be booked by contacting his secretary on 020 3960 1705 or by email at patelpa@gop.health. He accepts both private medical insurance and self pay patients.

Does Mr Shelain Patel offer second opinions?

Yes. Through his role at the Royal National Orthopaedic Hospital he provides specialist second opinions for patients facing complex foot deformity or who have had unsuccessful previous treatment.

Symptoms of ankle arthritis

Shelain Patel

Ankle arthritis can cause pain, stiffness, swelling and difficulty walking. Symptoms vary considerably between patients and often depend on the severity of cartilage damage, the underlying cause of the arthritis and the activities you need or want to perform.

Early ankle arthritis may cause discomfort only during higher-impact activities. As arthritis progresses, symptoms can become more persistent and may affect walking, stairs, uneven ground and everyday activities.

Mr Shelain Patel is a Consultant Orthopaedic Foot & Ankle Surgeon in London with specialist expertise in ankle arthritis, ankle replacement and complex foot and ankle conditions.

What does ankle arthritis feel like?

The most common symptoms include:

ankle pain
stiffness
swelling
reduced walking distance
pain during exercise
difficulty walking on uneven ground
discomfort on stairs
grinding or catching
reduced ankle movement
progressive deformity

Symptoms do not always correspond directly to the appearance of arthritis on an X-ray. Some patients with significant radiographic arthritis have relatively modest symptoms, while others can experience substantial pain despite apparently less advanced changes.

Ankle pain

Pain is usually the most important symptom. Arthritic ankle pain often becomes worse with weight-bearing activities such as walking, running or prolonged standing. Some people initially notice pain only after activity. With progression, pain may begin during ordinary walking and can sometimes occur at rest. The location and character of pain can vary depending on the areas affected.

Ankle stiffness

Stiffness is another common symptom.

You may notice difficulty moving your ankle when:

walking uphill
walking downstairs
squatting
running
climbing stairs
getting up after sitting
walking on uneven surfaces

Morning stiffness can occur, although prolonged stiffness may also occur after periods of inactivity.

Swelling

Arthritis can cause swelling around the ankle, particularly after prolonged activity. Swelling may fluctuate depending on activity levels and inflammation within the joint. Persistent or increasing swelling should be assessed, particularly if accompanied by pain, warmth or a significant change in function.

Reduced walking distance

As ankle arthritis progresses, walking may become increasingly difficult.

You may find that you need to:

take more frequent breaks
reduce the distance you walk
avoid hills
avoid uneven surfaces
alter your exercise routine
use a walking aid

This reduction in mobility can sometimes have a greater impact on quality of life than the pain itself.

Difficulty with sport and exercise

Running, jumping and other high-impact activities can become increasingly uncomfortable.

Some patients adapt their activities rather than stopping exercise completely. Cycling, swimming and other lower-impact activities may remain possible depending on the severity of the arthritis.

Grinding, catching or clicking

Some patients experience grinding, clicking or catching within the ankle. These sensations can occur because of changes to the joint surfaces, loose bodies or altered joint mechanics. Clicking by itself does not necessarily mean that significant arthritis is present.

Progressive deformity

Advanced ankle arthritis can sometimes result in progressive changes in alignment.

The ankle may gradually become tilted or the hindfoot may change position.

Deformity is particularly important when considering surgery because it may influence whether additional reconstructive procedures are required.

Pain at rest or at night

More advanced arthritis can cause pain at rest or at night.

Night pain is not specific to arthritis, however, and persistent unexplained pain should be properly assessed rather than assumed to be caused by arthritis.

How do ankle arthritis symptoms progress?

Symptoms often develop gradually, but progression varies.

A typical pattern may be:

Early stage - Pain with high-impact activity, mild stiffness and occasional swelling.

Intermediate stage - Pain with longer walks, reduced exercise tolerance and increasing stiffness.

Advanced stage - Pain with ordinary walking, substantial stiffness, swelling, reduced mobility and potentially pain at rest.

This pattern is not universal. Some people experience relatively stable symptoms for prolonged periods.

Ankle arthritis or something else?

Not every painful ankle is caused by arthritis.

Other conditions can produce similar symptoms, including:

Achilles tendinopathy
ankle instability
osteochondral lesions of the talus
ankle impingement
tendon disorders
stress fractures
ligament injuries
inflammatory conditions

This is why clinical assessment is important before deciding on treatment.

When should I see a foot and ankle specialist?

Specialist assessment may be appropriate if:

ankle pain persists despite simple treatment
pain is affecting your walking
you have increasing stiffness
you are repeatedly unable to participate in sport
you have recurrent swelling
you have had a previous significant ankle injury
you have a history of ankle fracture
your ankle appears to be becoming deformed
symptoms are progressively worsening

An assessment can establish whether arthritis is present and whether there are other problems contributing to your symptoms.

How is ankle arthritis diagnosed?

Diagnosis usually involves a clinical examination and appropriate imaging.

Weight-bearing X-rays or a CT scan are commonly used to assess:

joint-space narrowing
bone changes
alignment
deformity
previous fractures
associated arthritis

CT and MRI may be useful in selected patients.

Read more about [diagnosing ankle arthritis].

What treatments are available?

Treatment depends on your symptoms and the severity and cause of the arthritis.

Non-surgical treatment may include:

physiotherapy
activity modification
footwear changes
orthotics
medication
injections

For advanced symptomatic arthritis, surgical options may include ankle replacement, ankle fusion or reconstructive procedures.

Read more about [ankle replacement surgery] and [ankle fusion for arthritis].

Frequently Asked Questions

What is the most common symptom of ankle arthritis?

Pain is usually the most prominent symptom, often accompanied by stiffness and swelling.

Can ankle arthritis cause swelling?

Yes. Swelling can occur because of inflammation within and around the ankle joint.

Can ankle arthritis cause pain at night?

Advanced arthritis can cause pain at rest or at night, although night pain has many possible causes and should be assessed if persistent.

Can you have severe ankle arthritis without severe pain?

Yes. The severity seen on an X-ray does not always correlate directly with symptoms.

Can ankle arthritis cause difficulty walking?

Yes. Pain, stiffness and deformity can all reduce walking distance and make uneven ground, stairs and hills more difficult.

Book a consultation

If ankle pain or stiffness is affecting your walking, work, exercise or quality of life, specialist assessment can help establish the diagnosis and discuss treatment options.

[Book a consultation with Mr Shelain Patel]