Deforming 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 when walking (rolling the foot and transferring the body weight from the heel to the toe) and also bear the weight of the human body.Arthrosis of the ankle joint is a kind of punishment for upright posture.However, many other factors also play a role in the development of the disease.At first, without the patient's attention, the cartilage cover of 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.With advanced arthrosis, a person cannot move without support and experiences severe pain, especially when leaning on the leg.If early and comprehensive treatment is not started, disability is possible several years after the onset of the disease.
Causes of disease development
Previous injuries of the ankle joint increase the likelihood of developing a degenerative process in it.
- Increase in body weight;
- Flat feet, congenital foot deformities (caudate foot, club foot);
- Metabolic disorders in diseases such as diabetes, gout, atherosclerosis of the veins of the legs;
- Previous joint injuries, for example, ligament injuries, ankle and foot fractures;
- Constant overloading of the joint causing microtrauma (in athletes and people carrying heavy loads);
- hereditary tendency to arthrosis of the joints;
- Previous joint inflammation (arthritis) in 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 a division into stages.If there is stage 1, the person has the ability to work;if arthrosis has progressed to the 2nd and 3rd stages, pain and limited mobility cause disability (temporary or complete).
Symptoms of ankle arthrosis
- "Starting" pain.This is one of the first signs of ankle arthrosis.Pain appears after prolonged sitting when trying to lean on the leg and may be accompanied by short-term stiffness of joint movement.After taking a few steps, the pain disappears;
- pain during and after physical activity;
- Aching pain at night is associated with an inflammatory process triggered due to the destruction of cartilage tissue;
- Crackling, clicking in the joint when moving;
- Swelling is noticeable, especially under the ankle;
- Restriction of movements;
- Weakness of the ligament apparatus due to hypotrophy of the periarticular muscles and the fact that a person begins to spare the painful leg;
- Joint deformation in the final stage of arthrosis.
Diagnostics
Arthrosis and its exacerbation should be distinguished 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, a test for CRP and uric acid.With arthrosis, these indicators are normal, but if the disease is in an acute stage, ESR and leukocytes may increase.X-rays, ultrasound, CT or MRI of the joint are used in 2 projections to determine the stage of arthrosis and obtain more detailed information about the pathology.If arthrosis is in the 1st stage, an X-ray examination may show a slight narrowing of the joint space.During the transition to stage 2, joint space is reduced by 40% or more of normal.And in the 3rd stage, it narrows significantly, it may be practically absent, bone growth and deformations appear.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- In the period of severe exacerbation (walking with a cane on the side of the healthy limb), loosen the ankle joint using a bandage;
- Impact loads (jumping, running), vibration, lifting heavy loads, standing for a long time;
- Body weight control;
- Quit smoking;
- Wearing a semi-rigid orthosis with joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- intra-articular and peri-articular glucocorticoids together with anesthetics to eliminate inflammation;
- vascular agents;
- muscle relaxant to relieve spasm of muscle tissue;
- chondroprotectors - intra-articular drugs are more effective.If it is impossible to take intra-articular injections, intramuscular or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Wearing orthopedic insoles, comfortable shoes with small heels;
- Gymnastics to strengthen the musculoskeletal system.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten the toes 10 times;
- while lying or sitting, pull your legs towards you and away from you 10 times;
- turn your legs 10 times;
- make circular movements with your legs clockwise and counterclockwise 10 times;
- sitting on a chair, put your feet on the floor together with your toes and heels, alternately move your legs forward and back, repeat 15-20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and in the ineffectiveness of conservative treatment, endoprosthetics of the ankle joint using a rod structure or Ilizarov device (arthrodesis) or removal of the destroyed cartilage cover and joint capsule is indicated.
Prevention
To reduce the risk of developing arthrosis, preference should be given to protein-rich foods in the diet, and spicy, salty, fried foods and alcoholic beverages should be excluded from the diet.
- Avoid joint injuries.For this, you should try not to wear shoes with unstable heels or very hard soles, and use special protective equipment when doing sports;
- Body weight control;
- You should follow a diet, that is, eat more protein-rich foods and avoid salty, spicy, fried and alcohol;
- Timely treatment and correction of metabolic disorders, endocrine and vascular diseases;
- Do the above exercises for the ankle joints.
The effectiveness of treatment for deforming arthrosis of the ankle joint depends on its stage of development and the presence of accompanying diseases.In any case, if conservative therapy is indicated, correction with drugs and physical methods, as well as orthopedic products, should be included.
Which doctor should I see?
If you have pain in the ankle, you should see 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 lower limbs, it will be useful to visit 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 should be examined by a nutritionist and choose the right diet.Non-drug treatment is carried out with the participation of a physiotherapist.