Deforming arthrosis most often affects the joints of the lower extremities, one of which is the ankle.These joints have great mobility in different planes and perform an important function when walking (rolling of the foot and transfer of body weight from heel to toe) and also support the weight of the human body.Arthrosis of the ankle joint is a kind of punishment for upright posture.But many other factors also play a certain role in the development of the disease.At first, without the patient realizing it, the cartilaginous lining of the joint begins to soften and thin, then breaks down, triggering the inflammatory process and the growth of bone tissue in the form of osteophytes.With advanced osteoarthritis, a person is unable to move without support and feels severe pain, especially when leaning on the leg.Disability is possible within a few years of disease onset if early and comprehensive treatment is not initiated.
Reasons for the development of the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process in it.
- Increased body weight;
- Flat feet, congenital foot deformities (caudal foot, clubfoot);
- Metabolic disorders in diseases such as diabetes, gout, atherosclerosis of the blood vessels of the legs;
- Previous joint injuries, for example damage to the ligament system, fractures of the ankles and foot bones;
- Constant overload of the joint, leading to microtraumas (in athletes and people carrying heavy loads);
- Hereditary predisposition to arthrosis of the joints;
- Previous inflammation of the joint (arthritis) of an infectious nature or in systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of a specific factor that caused the disease, ankle arthrosis can be primary or secondary.There is also a division into phases.If stage 1 is present, a person is able to work;if osteoarthritis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle arthritis
- "Initial" pain.This is one of the first symptoms of ankle arthritis.The pain appears after prolonged sitting when trying to lean on the leg and may be accompanied by short-term stiffness of movements in the joint.After taking a few steps, the pain disappears;
- Pain during and after physical activity;
- Painful nocturnal pain, is associated with an inflammatory process that is triggered due to the destruction of cartilaginous tissue;
- Creaking, clicking in the joint during movement;
- Swelling, particularly noticeable under the ankles;
- Limitation of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligament apparatus due to the fact that a person begins to spare the sore leg;
- Joint deformation in the last stage of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its exacerbation from various inflammatory processes in the joint, for example due to rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood test, rheumatoid tests, a test for PCR and uric acid.With arthrosis, these indicators are normal, but if the disease is in the acute stage, ESR and leukocytes may increase.To establish the stage of arthrosis and obtain more detailed information about the pathology, radiography in 2 projections, ultrasound, CT or MRI of the joint is used.An x-ray may show slight narrowing of the joint space if the osteoarthritis is stage 1. As the arthritis progresses to stage 2, the joint space becomes 40% or more narrower than normal.And at the 3rd stage it is significantly narrowed, it can be practically absent, growths and deformations of the bones are visible.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- Unload the ankle joint during a period of severe exacerbation (walking with a stick on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibrations, heavy lifting, long periods of standing;
- Body weight control;
- Stop smoking;
- Wearing a semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetotherapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with intra-articular and periarticular anesthetics to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate spasm of muscle tissue;
- chondroprotectors: drugs administered intra-articularly are more effective.If it is not possible to receive intra-articular injections, intramuscular administration or oral administration is indicated;
- Hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wear comfortable shoes with small heels;
- Gymnastics to strengthen the musculo-ligament system.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your feet towards you and away from you 10 times;
- turn your feet out and in 10 times;
- make circular movements with your feet clockwise and anticlockwise 10 times;
- sitting on a chair, place your feet on the floor with your toes and heels together, alternately move your legs back and forth, repeat 15-20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and in case of ineffectiveness of conservative treatment, endoprosthesis of the ankle joint or removal of the destroyed cartilaginous lining and joint capsule with its closure using a rod structure or Ilizarov apparatus (arthrodesis) is indicated.
Prevention
To reduce the risk of developing arthrosis, preference should be given to foods rich in protein in the diet, and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injuries.To do this you must try not to wear shoes with unstable heels or soles that are too hard, and use special protective devices when practicing sports;
- Check body weight;
- It is necessary to stick to a diet, that is, eat more protein-rich foods and abstain from salty, spicy, fried and alcoholic foods;
- Timely treat and correct metabolic disorders, endocrine and vascular diseases;
- Perform the above exercises for the ankle joints.
The effectiveness of treatment for deforming arthrosis of the ankle joint depends on the stage of its development and the presence of concomitant diseases.In any case, if conservative therapy is indicated, this should include drugs and physical methods, in addition to correction with orthopedic products.
Which doctor should I contact?
If you have pain in the ankle joint, you should consult a rheumatologist.The doctor will prescribe exercises, medications and identify the cause of the disease.If you suffer from diabetes or gout it will be useful to visit an endocrinologist;if you have atherosclerosis of the vessels of the lower extremities, it will be useful to visit a vascular surgeon and a cardiologist.An important role in the treatment is played by the orthopedist: he will not only help you choose the right shoes and orthopedic insoles, but will also perform surgery if necessary.If you are overweight, you need to be examined by a nutritionist and select proper nutrition.Non-drug treatment is carried out with the participation of a physiotherapist.