Deforming arthrosis most often affects the joints of the lower limbs, one of which is the ankle.These joints provide great mobility in different planes and perform an important function during walking (rolling the foot and transferring body weight from the heel to the toes) and 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.At first, without the patient noticing, the cartilage covering of the joint begins to soften and thin, and then cracks, which initiates the inflammatory process and the growth of bone tissue in the form of osteophytes.In advanced arthrosis, the person cannot 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 the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process.
- Increased body weight;
- Flat foot, congenital foot deformity (clubfoot, clubfoot);
- Metabolic disorders in diseases such as diabetes, gout, arteriosclerosis of the legs;
- Previous joint injuries, such as ligament damage, broken ankle and foot bones;
- Constant overloading of the joint, which leads to microtrauma (in athletes and people carrying heavy loads);
- Hereditary tendency to arthrosis of the joints;
- Previous arthritis (arthritis), infectious or 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 division into sections.If stage 1 is present, the person is able to work;if arthrosis has progressed to stage 2 and 3, pain and limited movement (temporary or total) lead to disability.
Symptoms of arthrosis of the ankle
- "Starting" pain.This is one of the early symptoms of ankle arthrosis.The pain occurs after prolonged sitting, when trying to support the leg, and may be accompanied by a short period of stiffness of motion in the joint.After taking a few steps, the pain goes away;
- Pain during and after physical activity;
- Aching pain at night, associated with an inflammatory process, which is caused by the destruction of cartilage tissue;
- Crackling, clicking in the joint during movement;
- Swelling, especially noticeable below the ankle;
- Restriction of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus is due to the fact that a person begins to spare his sore leg;
- Joint deformation in the last stage of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its aggravation from various inflammatory processes of the joints, for example due to rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood test, rheumatic tests, CRP test and uric acid test.In the case of arthrosis, these indicators are normal, but if the disease is in an acute stage, the ESR and leukocytes may increase.To determine the stage of arthrosis and to obtain more detailed information about the pathology, 2-dimensional radiography, ultrasound of the joint, CT or MRI are used.X-rays may show a slight narrowing of the joint space if the arthrosis is in stage 1.When moving to stage 2, the joint space is reduced by at least 40% compared to normal.And in the 3rd stage, it is significantly narrowed, it can practically be absent, growths and deformations of the bones are visible.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and, of course, treatment.
- Relief of the ankle joint during a severe exacerbation (walking with a cane on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibration, heavy lifting, long standing positions;
- Body weight control;
- Stop smoking;
- Wearing a semi-rigid orthosis with simultaneous joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnet therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids with anesthetics intra-articularly and peri-articularly to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate spasm of muscle tissue;
- chondroprotectors - drugs administered intra-articularly are more effective.If intra-articular injection is not possible, intramuscular or oral administration is recommended;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Wearing orthopedic insoles, comfortable shoes with small heels;
- Gymnastics for strengthening the muscle-ligament apparatus.The recommended exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your leg towards you and away from you 10 times;
- turn your legs out and 10 times;
- make circular movements with your legs clockwise and counterclockwise 10 times;
- sitting on a chair, place your feet on the floor with the toes and heels together, alternately move your feet forward and backward, repeat 15-20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and in case of failure of conservative treatment, endoprosthesis of the ankle joint or removal of the destroyed cartilage covering and joint capsule by closing it 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 high-protein foods 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 too hard soles and use special protective equipment during sports;
- Weight control;
- You must follow a diet, that is, you must eat more protein-rich foods and refrain from salty, spicy, fried and alcoholic foods;
- Treat and correct metabolic disorders, endocrine and vascular diseases in a timely manner;
- Do the above exercises for the ankle joints.
The effectiveness of the treatment of deforming arthrosis of the ankle joint depends on the stage of development and the presence of concomitant 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 see?
If you feel pain in the ankle joint, consult a rheumatologist.The doctor prescribes exercises, medicines and identifies the cause of the disease.If you suffer from diabetes or gout, it will be helpful to see an endocrinologist;if you have arteriosclerosis of the vessels of the lower limbs, it will be useful to visit a vascular surgeon and a cardiologist.The orthopedist plays an important role in the treatment - he not only helps in choosing the right shoes and orthopedic insoles, but also performs surgery if necessary.If you are overweight, you should see a nutritionist and choose the right diet.The non-drug treatment is carried out with the participation of a physiotherapist.