Deforming osteoarthritis most often affects the joints of the lower limbs, including the ankle. These joints have high mobility 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. Arthrosis of the ankle joint is a kind of retribution for walking upright. But many other factors play a role in the development of the disease. First, imperceptibly for the patient, the softening and thinning of the cartilaginous coating of the joint begins, then it cracks, which triggers the inflammatory process, the growth of bone tissue in the form of osteophytes. With advanced osteoarthritis, a person is unable to move without support and experiences severe pain, especially when pressing on the leg. Disability is possible a few years after 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 that a degenerative process will develop there.
- Increase in body weight;
- Flat feet, congenital malformations of the feet (horse foot, club foot);
- Metabolic disorders in diseases such as diabetes mellitus, gout, atherosclerosis of the vessels of the legs;
- Past joint injuries, for example, damage to the ligamentous apparatus, fractures of the ankles and foot bones;
- Constant overload of the joint, leading to microtraumas (in athletes and people who carry heavy loads);
- Hereditary predisposition to arthrosis of the joints;
- Previous inflammation of the joint (arthritis) of an infectious nature or with systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of a specific factor causing the disease, ankle osteoarthritis can be primary or secondary. There is also a division into stages. In the presence of the 1st stage, a person is able to work, if arthrosis has progressed to the 2nd and 3rd stages, pain and reduced mobility lead to disability (temporary or complete).
Symptoms of osteoarthritis of the ankle
- "Starting" pain. It is one of the first symptoms of osteoarthritis of the ankle. Pain appears after prolonged sitting when trying to lean on the leg, may be accompanied by short-term stiffness of movements in the joint. After taking a few steps, the pain disappears;
- Pain during and after physical exertion;
- Painful night pain, it is associated with an inflammatory process that is triggered due to the destruction of cartilage tissue;
- Crunch, clicks in the joint during movement;
- 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 sore leg;
- Joint deformity in the last stage of osteoarthritis.
Diagnostic
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, rheumatoid tests, a test for CRP, uric acid. With arthrosis, these indicators are normal, but if the disease is in the acute stage, ESR and leukocytes may be increased. To establish the stage of osteoarthritis and obtain more detailed information on the pathology, radiography in 2 projections, ultrasound, CT or MRI of the joint is used. On the x-ray, a slight narrowing of the joint line can be noted if the osteoarthritis is at the 1st stage. When moving to the 2nd stage, the joint space is reduced by 40% or more compared to the norm. And at the 3rd stage, it is significantly narrowed, it can be practically absent, growths and deformities of the bones are visible.
Treatment methods
Arthrosis of the ankle joint, as well as other localizations, involves complex, long-term and ongoing treatment.
- Unload the ankle joint during a period of severe exacerbation (walking with a cane on the side of a healthy limb), the use of a bandage;
- Exclusion of shock loads (jumping, running), vibration, weight transfer, prolonged stay on the legs;
- Body weight control;
- Stop smoking;
- Wearing a semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Medical therapy:
- NSAIDs externally, orally, in injections;
- glucocorticoids combined with intra-articular and peri-articular anesthetics to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate spasms of muscle tissue;
- chondroprotectors are more effective drugs administered intra-articularly. If it is not possible to receive intra-articular injections, intramuscular administration, oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wear comfortable shoes with a small heel;
- Gymnastics to strengthen the musculoskeletal system. The following exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull the feet towards you and away from you 10 times;
- turn the feet outward and inward 10 times;
- make circular movements with the feet clockwise and counterclockwise 10 times;
- sitting in a chair, put your feet on the floor with your toes and heels together, alternately rearrange your legs forward and backward, repeat 15-20 times.
- Swimming, water aerobics;
- At the 3rd stage of arthrosis and the ineffectiveness of conservative treatment, endoprosthesis replacement of the ankle joint or removal of the destroyed cartilage coating and the joint capsule with its closure with the help of a structurestem or Ilizarov apparatus (arthrodesis) is indicated.
Prevention
To reduce the risk of developing osteoarthritis, foods should be favored over protein-rich foods, and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injury. To do this, you need to try not to wear shoes with unstable heels, too hard soles, use special protective equipment when playing sports;
- Control body weight;
- You need to stick to a diet, that is, eat more protein-rich foods and refrain from consuming salty, spicy, fried alcohol;
- Timely treatment and correction of metabolic disorders, endocrine and vascular diseases;
- Perform the above exercises for the ankle joints.
The effectiveness of treatment of deforming arthrosis of the ankle joint depends on the stage of its development and the presence of concomitant diseases. In any case, if conservative treatment is indicated, it should include both medication and physical methods, as well as correction with orthopedic products.
Which doctor to contact
For pain in the ankle joint, you should consult a rheumatologist. The doctor will prescribe exercises, medications and identify the cause of the disease. In case of diabetes or gout, it will be useful to consult an endocrinologist, in case of atherosclerosis of the vessels of the lower extremities - a vascular surgeon and a cardiologist. An orthopedist plays an important role in the treatment - he will not only help you choose the right shoes, orthopedic insoles, but also perform an operation if necessary. If you are overweight, you need to consult a nutritionist and choose the right diet. Non-drug treatment is carried out with the participation of a physiotherapist.