Deforming arthrosis most often affects the joints of the lower extremities, one of which is the ankle joint.These joints have great mobility in different planes and perform an important function when walking (rolling the foot and transferring body weight from heel to toe), and also bear the weight of the human body.Arthrosis of the ankle joint is a kind of retribution for upright posture.But many other factors also play a certain role in the development of the disease.First, unnoticed by the patient, the cartilaginous covering of the joint begins to soften and thin, then burst, which causes an inflammatory process and the growth of bone tissue in the form of osteophytes.In advanced arthrosis, a person cannot move without support and feels severe pain, especially when leaning on the leg.Disability is possible within a few years of 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 in it.
- Increased body weight;
- Flat feet, congenital foot deformities (cauda feet, club feet);
- 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 apparatus, fractures of the ankle joints and bones of the foot;
- Constant overloading of the joint, which leads to microtrauma (in athletes and people who carry heavy loads);
- Hereditary predisposition to arthrosis of the joints;
- Previous joint inflammations (arthritis) of an infectious nature or systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of a specific factor that caused the disease, arthrosis of the ankle joint can be primary or secondary.There is also a division into phases.If stage 1 is present, the person is able to work;if arthrosis has progressed to stage 2 and 3, pain and limited mobility lead to disability (temporary or total).
Symptoms of arthrosis of the ankle joint
- "Initial" pain.This is one of the early symptoms of ankle arthrosis.The pain occurs after sitting for a long time when trying to rest on the leg, and it can be accompanied by a short-term stiffness of movement in the joint.After a few steps, the pain disappears;
- Pain during and after physical activity;
- Painful pain at night is associated with an inflammatory process that is triggered by the destruction of cartilage tissue;
- Creaking, clicking in the joint when moving;
- Swelling, especially noticeable below the ankles;
- Restriction of movement;
- Hypotrophy of the periarticular muscles and weakness of the ligament apparatus due to the fact that the person begins to spare the painful leg;
- Deformation of the joint in the last stage of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its worsening from various inflammatory processes in the joint, for example, as a result of rheumatoid gout or psoriatic arthritis.That is why the doctor prescribes a detailed blood analysis, rheumatoid tests, CRP and uric acid tests.In arthrosis, these indicators are normal, but if the disease is in an acute phase, ESR and leukocytes may be increased.To determine 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 a slight narrowing of the joint space if the osteoarthritis is in stage 1. By moving to stage 2, the joint space is reduced by 40% or more than normal.And in the 3rd stage, it is significantly narrowed, it can be practically absent, bone growths and deformations are visible.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- Relief of the ankle joint in the period of severe exacerbation (walking with a cane on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibration, lifting heavy loads, standing for long periods of time;
- Body weight control;
- Smoking cessation;
- Wearing a semi-rigid orthosis with accompanying joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with anesthetics intra-articularly and peri-articularly to relieve inflammation;
- vascular agents;
- muscle relaxants to remove muscle tissue spasms;
- chondroprotectors - drugs applied 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, wearing comfortable shoes with small heels;
- Gymnastics for strengthening the muscle-ligament apparatus.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten the toes 10 times;
- while lying down or sitting, pull your feet towards you and away from you 10 times;
- turn your feet in and out 10 times;
- make circular movements with your legs clockwise and counterclockwise 10 times;
- sitting on a chair, put your feet on the floor with your toes and heels together, alternately move your legs forward and back, repeat 15-20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and inefficiency of conservative treatment, endoprosthetics of the ankle joint or removal of the destroyed cartilage and joint capsule with its closure with a rod structure or Ilizarov device (arthrodesis) is indicated.
Prevention
In order to reduce the risk of developing arthrosis, preference should be given to foods with a high protein content 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 too hard soles and use special protective equipment when playing sports;
- Body weight control;
- You must stick to a diet, that is, eat more protein-rich food and refrain from salty, spicy, fried and alcohol;
- Treat and correct metabolic disorders, endocrine and vascular diseases in a timely manner;
- Perform the above ankle exercises.
The effectiveness of the treatment of deforming arthrosis of the ankle joint depends on the degree of its development and the presence of accompanying diseases.In any case, if conservative therapy is indicated, it should include drugs and physical methods, as well as correction with orthopedic products.
Which doctor should I contact?
If you have pain in the ankle joint, consult a rheumatologist.The doctor will prescribe exercises, medicines and determine 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 blood vessels of the lower extremities, it will be useful to see a vascular surgeon and a cardiologist.An orthopedist plays an important role in treatment - he will not only help you choose the right shoes and orthopedic insoles, but also perform surgery if necessary.If you are overweight, you need to see a nutritionist and choose the right diet.Treatment without drugs is carried out with the participation of a physiotherapist.