Deformative 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 during walking (rotating the foot and transferring the weight of the body from the heel to the toe), as well as supporting the weight of the human body.Ankle arthrosis is a kind of punishment for upright posture.But many other factors also play a certain role in the development of the disease.Initially, without being noticed by the patient, the cartilaginous covering of the joint begins to soften and thin, then it cracks, which promotes the inflammatory process and the growth of bone tissue in the form of osteophytes.With advanced arthrosis, a person is unable to move without support and experiences severe pain, especially when leaning on the leg.Disability is possible within a few years after the onset of the disease if early and comprehensive treatment is not started.
Causes of disease development
Previous ankle injuries increase the possibility of developing a degenerative process in it.
- Increase in body weight;
- Flat feet, congenital deformities of the feet (caudate 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 the joints and bones of the leg;
- Continuous overload of the joint, leading to microtrauma (in athletes and people carrying heavy loads);
- Hereditary predisposition to joint arthrosis;
- Previous inflammation of the joint (arthritis) of an infectious nature or in systemic diseases (rheumatoid arthritis, psoriatic, gout).
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 stages.If stage 1 is present, a person is able to work;if arthrosis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle arthrosis
- "Starting" pain.This is one of the early symptoms of ankle arthrosis.Pain appears after prolonged sitting when trying to support 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 caused due to the destruction of cartilage tissue;
- Crackling, clicking in joints when moving;
- Swelling, especially noticeable under the ankles;
- Restriction of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that a person begins to spare the injured leg;
- Deformation of joints in the last stage of arthrosis.
Diagnosing
It is necessary to distinguish arthrosis and its deterioration from various inflammatory processes in the joints, for example, as a result of rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood analysis, rheumatoid tests, a test for CRP and uric acid.With arthrosis, these indicators are normal, but if the disease is in the acute phase, ESR and leukocytes may increase.To determine the stage of arthrosis and to 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 a slight narrowing of the joint space if the osteoarthritis is in stage 1. After progressing to stage 2, the joint space is reduced by 40% or more of normal.And in the 3rd stage it is significantly narrowed, it can be practically absent, bone growths and deformations are visible.
Treatment methods
Osteoarthritis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- Discharge of the ankle joint during a period of severe deterioration (walking with a cane on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibration, heavy lifting, long periods of standing;
- Body weight control;
- Quitting smoking;
- Wearing a semi-rigid orthosis with associated joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with anesthetics intra-articularly and periarticularly 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 take intra-articular injections, intramuscular administration or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic poles, wearing comfortable shoes with small heels;
- Gymnastics to strengthen the muscular-ligamentous apparatus.The suggested exercises should be performed every day:
- lying down or sitting, bend and straighten the toes 10 times;
- lying down or sitting, pull your legs towards you and away from you 10 times;
- turn the legs out and in 10 times;
- make circular movements with your legs clockwise and counter-clockwise 10 times;
- sitting on a chair, put your feet on the floor with toes and heels together, move your legs alternately forward and backward, repeat 15-20 times.
- Swimming, water aerobics;
- In the third stage of arthrosis and ineffectiveness of conservative treatment, endoprosthetics of the ankle joint or removal of the destroyed cartilage cover and joint capsule with its closure using a rod structure or an Ilizarov apparatus (arthrodesis) is indicated.
Preventing
To reduce the risk of developing arthrosis, priority 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 soles or very hard soles and use special protective equipment when playing sports;
- Check body weight;
- You must adhere to a diet, that is, eat more protein-rich foods and refrain from salty, spicy, fried 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 depends on the stage of its development and the presence of accompanying diseases.In any case, if conservative therapy is indicated, it should include medications and physical methods, as well as correction with orthopedic products.
Which doctor should I contact?
If you have ankle pain, you should 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 visit a vascular surgeon and cardiologist.An orthopedist plays an important role in treatment - he will not only help you choose the right orthopedic shoes and insoles, but will also perform surgery if necessary.If you are overweight, you should be examined by a nutritionist and choose the right food.Non-drug treatment is carried out with the participation of a physiotherapist.