Arthrosis of the ankle joint -degenerative-dystrophic damage to cartilaginous tissue. But since as the disease progresses, the articular surfaces of the bones are involved in the process, it is more correct to call it osteoarthritis. In foreign literature, when describing this disease, the term osteoarthritis is used, which indicates not only degenerative changes, but also inflammation in this context.
Osteoarthritis -This is a chronic and progressive joint disease in which the cartilage, articular surfaces of bones, capsule and periarticular tissues are destroyed. This leads to pain and impaired joint mobility. The ankle rarely presents with osteoarthritis, unlike the knee. The disease occurs more frequently in women over 50 and in athletes who have suffered foot injuries. With arthrosis of the ankle joint, treatment depends on the manifestations of the disease and is selected individually by an orthopedic traumatologist. Doctors use methods that have proven their effectiveness and safety and practice a multidisciplinary approach to treat the problem and prevent the progression of joint pathology.
This article is advisory in nature. Treatment is prescribed by a specialist after consultation.
How the disease develops
The ankle joint is formed by three bones: tibia, fibula and talus, covered by a joint capsule and strengthened by ligaments. Thanks to the work of muscles, the foot bends and extends. Normally, the articular surfaces are smooth and easily slide relative to each other during movements. Covered by dense and elastic cartilage, its main function is cartilage. bone protection and load absorption. The joint cavity contains synovial fluid. It plays the role of intra-articular lubrication, preventing friction of the joint elements and their abrasion during movements.
But as a result of injury or natural aging of the joint, the articular surfaces become rough and the cartilaginous tissue loses its smoothness and elasticity. When cartilage is damaged and as degenerative changes progress, bones begin to come into contact with each other as they move in the joint, which is accompanied by pain.
In an attempt to "defend"and to compensate for additional damage to the joints and surrounding tissues, osteophytes are formed - osteophytes. growth along the edges of the articular surfaces of bones. As a result, joint mobility is partially or completely limited.
Depending on the root cause, the following types of osteoarthritis are distinguished:
- Primary or idiopathic osteoarthritis. In this case we are talking about degenerative dystrophic changes in the joint
- Secondary is associated with exposure to a specific causal factor, usually a previous joint injury. And this form is most often diagnosed
Predisposing factors
The main predisposing factors for the development of arthrosis of the ankle joint:
- intra- and periarticular injuries, such as bone fractures, ruptures, and ligament ruptures
- ankle surgery
- inflammatory joint injuries in the past
- intense loads: professional sports, ballet, long walks, work associated with long periods of "standing"
- sedentary lifestyle
- wear high heels for a long time
- overweight
- hereditary collagenopathies leading to impaired collagen synthesis
- chronic damage to joint structures due to excessive loads
- metabolic disorders: diabetes, gout
- estrogen deficiency in postmenopausal women
- rheumatic diseases
- foot deformities, such as flat feet
- degenerative-dystrophic changes in the spine, complicated by the formation of an intervertebral hernia, which is accompanied by compression of the nerve root
Ankle osteoarthritis: symptoms
The main sign of osteoarthritis — Pain is what makes you seek help from a doctor. At the beginning of the development of the disease, the pain is only bothersome after prolonged exercise and decreases with rest.
Depending on the stage of pathological changes in the joint, the pain becomes more intense and persists at rest and even at night. Other symptoms occur.
There are three stages of the disease:
- The first phase is characterized by slight swelling, redness of the skin in the joint area, pain in the afternoon or after intense exercise. Unpleasant sensations are localized along the front surface of the foot, along the joint line and pass to the lateral surfaces of the ankle. An x-ray of the foot may still show no changes.
- In the second stage, the pain becomes constant, there is a clicking sound when moving the joint, mobility is limited and the joint "gets stuck". When examined on an x-ray, growths are visible along the edges of the articular surfaces of the bones: tibia, ankles and talus, as well as narrowing of the joint space
- In the third stage, the joint is deformed, so only rocking and low-amplitude movements are possible. The x-ray reveals massive bone growths, the joint space is strongly narrowed or even absent. Due to the instability of the joint, patients often twist their leg, which only aggravates the situation due to sprains, ligament ruptures and deterioration of the general condition
Pain in ankle arthrosis has characteristic features:
- Maximum expressed at the beginning of the movement — the so-called initial pain
- Increases significantly with load, especially when running, jumping
- Often appears at night, at night or immediately after waking up
Due to the pain, there is limited mobility of the foot, as well as blockage of the joint as the cartilage is destroyed.
Symptoms manifest in waves: exacerbations alternate with remissions. With an exacerbation, the symptoms are more pronounced. During remission, symptoms gradually decrease and may even disappear completely.
Which doctor should I contact?
If pain and stiffness occur when moving the ankle, you should consult an orthopedic traumatologist. If another cause of joint discomfort is identified, consultation with a neurologist, rheumatologist or endocrinologist may be necessary.
Diagnosis
To make a diagnosis, the doctor clarifies the complaints, specifies how long the pain has been observed, which contributes to its appearance and intensification. The specialist collects data on existing diseases, injuries and lifestyle features, conducts examinations, assesses the range of motion of the joint and conducts diagnostic examinations.
Already on the basis of the information received, it is possible to make a diagnosis, but to confirm it and draw up a competent treatment plan, additional examination methods are needed, which may include:
- X-ray of the ankle joint, which is of fundamental importance in diagnosing and determining the stage of disease progression. The images show narrowing of the joint space, osteophytes on the edges of the articular surfaces of the bones, cysts and signs of thinning of the bone located under the cartilage
- A CT scan of the joint reflects the image in more detail. The doctor can assess in detail the condition of the patient's bone structures and cartilaginous tissue
- MRI is used to study cartilage and soft tissue
- Joint ultrasound to assess the condition of soft joint structures
Osteoarthritis treatment
Treatment of the pathology is long-term and carried out under the supervision of an orthopedic traumatologist on an outpatient basis. How to cure arthrosis of the leg depends on the stage of damage and existing complications.
The main goals of treating the disease in a modern clinic are to relieve leg pain, improve the patient's quality of life and slow down the progression of osteoarthritis. To do this, the doctor develops a set of therapeutic and preventive measures, medicinal and non-medicinal, and also adjusts the patient's lifestyle.
Lifestyle correction and nutrition
Sufficient physical activity and nutritional correction will help contain degenerative changes. After the examination, the clinic's doctors can give recommendations on weight loss, as well as optimizing the load on the legs.
Drug treatment
Medicines are selected individually, based on examination data, symptoms and concomitant diseases. The patient may be prescribed:
- Painkillers. Most often these are non-steroidal anti-inflammatory drugs in the form of tablets, gels, injections to relieve pain and inflammation.
- Antidepressants and anticonvulsants for prolonged, severe, difficult-to-treat pain
Exercise therapy
Specially selected exercises help maintain joint range of motion, reduce pain and contain the progression of degenerative changes. The patient performs the recommended exercises initially under the supervision of a specialist, and then - under the supervision of a specialist. alone, at home.
Massage
Lower limb massage normalizes the nutrition of articular tissues. It is prescribed outside the acute phase. During the session, the specialist performs passive movements in the joint, which prevents muscle shortening and joint stiffness.
Assistive devices
Special braces, canes, and walkers may be recommended to relieve stress and stabilize the ankle joint.
Surgery
It is only used in cases of severe destruction of the articular cartilage and limitation of joint mobility. After the operation there is a long period of rehabilitation and conservative treatment. Endoprosthetics or arthroplasty in the later stages of development of ankle arthrosis -practically the only opportunity to avoid disability and maintain joint mobility.
Why is ankle osteoarthritis dangerous?
The changes already formed in the joint are irreversible. Therefore, treatment aims to slow down the pathological process in order to preserve the patient's ability to work and quality of life. It is possible to achieve such goals only with timely treatment and strict adherence to the doctor's recommendations.
As arthrosis develops, a pronounced deformation of the joint forms. The range of motion decreases sharply, as a result, the ability to support the foot becomes difficult, walking without crutches or a cane is almost impossible.
Chronic and constant joint pain leads to anxiety and depressive disorders.
Prevention
Prevention of osteoarthritis includes the following measures:
- Avoid traumatic activities. For example, jumping from great heights, running
- Avoid injuries
- Be careful in icy conditions, wear non-slip shoes
- Control your body weight
- Normalizing body weight will help reduce stress on the ankle joint
- Stay moderately active
- An inactive lifestyle is dangerous and leads to complications, as well as excessive overload and microtraumas
- Keep your joints healthy
- Consult a doctor immediately and treat musculoskeletal disorders
Main points of the article:
- The prevalence of degenerative dystrophic diseases of the foot joints is 87%
- Occupational hazards, daily habits and previous injuries can lead to osteoarthritis of the ankle joint.
- A common symptom of arthrosis — pain, which is accompanied by a crunching sound when moving, local swelling and subsequently limited mobility of the foot
- The treatment of ankle osteoarthritis is usually conservative and includes medicinal and non-drug methods.
- Progression of ankle osteoarthritis leads to disability and complete loss of foot function