Deforming osteoarthritis 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 the foot and transferring body weight from the heel to the toe), in addition to supporting the weight of the human body.Arthrosis of the ankle joint is a kind of retribution for the upright posture.But many other factors also play a certain role in the development of the disease.First, unnoticed by the patient, the cartilage that covers the joint begins to soften and thin, then cracks, which triggers the inflammatory process and the growth of bone tissue in the form of osteophytes.In advanced osteoarthritis, the person cannot move without support and feels severe pain, especially when leaning on the leg.Disability is possible a few years after the onset of the disease if early and comprehensive treatment is not started.
Reasons for the development of the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process.
- Increase in body weight;
- Flat feet, congenital foot deformities (tail of the 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 ligamentous apparatus, fractures of ankles and bones of the foot;
- Constant overload of the joint, leading to microtraumas (in athletes and people carrying heavy loads);
- Hereditary predisposition to osteoarthritis 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 causing the disease, ankle arthrosis can be primary or secondary.There is also a division into stages.If stage 1 is present, the person is able to work;If osteoarthritis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Ankle osteoarthritis symptoms
- "Initial" pain.This is one of the first symptoms of ankle osteoarthritis.The pain appears after sitting for a long time when trying to lean on the leg and may be accompanied by short-term stiffness of movement in the joint.After taking a few steps, the pain goes away;
- Pain during and after physical activity;
- Aching pain at night is associated with an inflammatory process that is triggered by the destruction of cartilaginous tissue;
- Grind, click the joint when moving;
- Swelling, especially noticeable under the ankles;
- Limitation of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that the person begins to spare the painful leg;
- Joint deformation in the last stage of osteoarthritis.
Diagnosis
It is necessary to distinguish arthrosis and its exacerbation from various inflammatory processes in the joint, for example, as a result of rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood test, rheumatoid tests, PCR and uric acid test.With arthrosis, these indicators are normal, but if the disease is in an acute stage, ESR and leukocytes may be increased.To establish the stage of arthrosis and obtain more detailed information about the pathology, radiography in 2 projections, ultrasound, computed tomography or magnetic resonance imaging of the joint are used.An x-ray may show a slight narrowing of the joint space if the osteoarthritis is in stage 1. In the transition to stage 2, the joint space is reduced by 40% or more of normal.And at the 3rd stage, it narrows significantly, 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 clear treatment.
- Unloading the ankle joint during a period of severe exacerbation (walking with a cane 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;
- Use of semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetotherapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with anesthetics intra-articularly and periarticularly to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate muscle tissue spasms;
- chondroprotectors – medications administered intra-articularly are more effective.If it is not possible to receive intra-articular injections, intramuscular or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, comfortable shoes with small heels;
- Gymnastics to strengthen the musculo-ligamentous apparatus.The suggested exercises should be performed daily:
- lying or sitting, bend and stretch your toes 10 times;
- lying or sitting, pull your feet towards you and in the opposite direction 10 times;
- turn your feet out and in 10 times;
- make circular movements with your feet clockwise and counterclockwise 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 to 20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and if conservative treatment is ineffective, endoprosthesis of the ankle joint or removal of the destroyed cartilaginous cover 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 should try not to wear shoes with unstable heels or very hard soles, and use special protective equipment when playing sports;
- Control body weight;
- It is necessary to follow a diet, that is, eat more foods rich in proteins and avoid salty, spicy, fried foods and alcohol;
- Treat and correct metabolic disorders, endocrine and vascular diseases in a timely manner;
- 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 must include medications and physical methods, in addition to correction with orthopedic products.
Which doctor should I contact?
If you experience pain in your ankle joint, consult a rheumatologist.The doctor will prescribe exercises, medications and identify the cause of the disease.If you have diabetes or gout, it will be helpful to see an endocrinologist;if you have atherosclerosis of the vessels of the lower extremities, it will be useful to consult a vascular surgeon and a cardiologist.The orthopedist plays an important role in treatment - he will not only help you choose the right orthopedic shoes and insoles, but also perform surgery if necessary.If you are overweight, you need to be examined by a nutritionist and select a suitable diet.Non-drug treatment is carried out with the participation of a physiotherapist.