Deforming osteoarthritis most commonly affects the joints of the lower extremities, including the ankle.These joints are very mobile in different planes and perform an important function when walking (rolling the foot and transferring body weight from the heel to the toe) and also support the weight of the human body.Ankle osteoarthritis is a form of retaliation for an upright posture.But many other factors also play a certain role in the development of the disease.First, the cartilage coating of the joint, unnoticed by the patient, becomes softer and thinner, then it tears, which triggers the inflammatory process and the growth of bone tissue in the form of osteophytes.With advanced osteoarthritis, the affected person can no longer move without support and experiences severe pain, especially when leaning on their leg.Disability is possible within a few years of the onset of the disease if treatment is not started early and comprehensively.
Reasons for the development of the disease
Previous injuries to the ankle joint increase the likelihood that a degenerative process will develop there.
- Increased body weight;
- Flat feet, congenital foot deformities (caudafoot, 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 ligaments, fractures of the ankle joints and foot bones;
- Constant overload of the joint, leading to microtrauma (in athletes and people carrying heavy loads);
- Hereditary predisposition to arthrosis of the joints;
- Previous joint inflammation (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 condition, ankle osteoarthritis can be primary or secondary.There is also a division into stages.If level 1 is present, a person is fit to work;When osteoarthritis has reached stages 2 and 3, pain and limited mobility lead to (temporary or total) disability.
Symptoms of ankle osteoarthritis
- “Initial pain”.This is one of the early symptoms of ankle osteoarthritis.Pain occurs after sitting for a long time when trying to support yourself on the leg and can be accompanied by short-term stiffness in the joint.After a few steps the pain disappears;
- pain during and after physical activity;
- Aching pain at night associated with an inflammatory process triggered by the destruction of cartilage tissue;
- Crunching, clicking in the joint when moving;
- swelling, particularly noticeable under the ankles;
- restriction of movement;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that a person begins to rest the sore leg;
- Joint deformation in the final stage of arthrosis.
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, rheumatism tests, a CRP and uric acid test.With arthrosis, these indicators are normal, but if the disease is in the acute stage, ESR and leukocytes may be increased.To determine the stage of arthrosis and obtain more detailed information about the pathology, X-rays in 2 projections, ultrasound, CT or MRI of the joint are used.In stage 1 osteoarthritis, a slight narrowing of the joint space can be seen on the x-ray.In the transition to the 2nd stage, the joint space is reduced by 40% or more compared to normal.And in the 3rd stage it is significantly narrowed, it may be practically absent, growths and deformations of the bones are visible.
Treatment methods
Osteoarthritis of the ankle joint, like other localizations, requires complex, long-term and progression-oriented treatment.
- Unloading 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 standing;
- control of body weight;
- quit smoking;
- Wearing a semi-rigid orthosis with simultaneous joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic field therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- Glucocorticoids along with anesthetics intra-articularly and periarticularly to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate muscle spasms;
- Chondroprotectors – drugs administered intra-articularly are more effective.If intra-articular injection is not possible, intramuscular or oral administration is indicated;
- Hyaluronic acid preparations to restore the quality of joint fluid.
- Wear orthopedic insoles, comfortable shoes with small heels;
- Gymnastics to strengthen the musculoskeletal system.The recommended exercises should be done daily:
- Lying or sitting, bend and straighten your toes 10 times;
- While lying or sitting, pull your feet toward and away from you ten times.
- Rotate your feet out and in 10 times.
- Make circular movements clockwise and counterclockwise with your feet 10 times;
- Sit on a chair, place your feet on the floor with your toes and heels together, move your legs forward and backward alternately, repeat the process 15-20 times.
- swimming, water aerobics;
- In the 3rd stage of arthrosis and the ineffectiveness of conservative treatment, endoprosthetics of the ankle joint or the removal of the destroyed cartilage cover and joint capsule with their closure using a rod construction or an Ilizarov device (arthrodesis) is indicated.
Prevention
To reduce the risk of developing arthrosis, foods rich in protein should be preferred in the diet and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injuries.To do this, you must be careful not to wear shoes with unstable heels or soles that are too hard and to use special protective equipment when playing sports;
- control body weight;
- You need to follow a diet, that is, eat more protein-rich foods and avoid salty, spicy, fried and alcoholic foods;
- Timely treat and correct metabolic disorders, endocrine and vascular diseases;
- Perform the above ankle exercises.
The effectiveness of treatment of deforming arthrosis of the ankle depends on the stage of development and the presence of concomitant diseases.If conservative therapy is indicated, it should in any case include medication and physical methods as well as correction with orthopedic products.
Which doctor should I contact?
If you have ankle pain, you should see a rheumatologist.The doctor will prescribe exercises and medications and determine the cause of the disease.If you suffer from diabetes or gout, it makes sense to see an endocrinologist;If you suffer from atherosclerosis of the vessels of the lower extremities, it makes sense to consult a vascular surgeon and cardiologist.An orthopedist plays an important role in treatment - he not only helps you choose the right shoes and orthopedic insoles, but also performs surgical procedures if necessary.If you are overweight, you need to be examined by a nutritionist and choose the right diet.The non-drug treatment takes place with the assistance of a physiotherapist.