Deformation of arthrosis most often affects the joints of the lower leg, one of which is the ankle.These joints have great mobility in different planes and perform important functions during walking (rolling the foot and transferring body weight from heel to foot), and also bear the weight of the human body.Arthrosis of the ankle joint is a kind of retaliation for upright posture.But many other factors also play a certain role in the development of this disease.First, without the patient realizing it, the cartilage cover of the joint begins to soften and thin, then crack, 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.Disability may occur in several years after the onset of the disease if early and comprehensive treatment is not initiated.
The reasons for the development of the disease
Previous injury to the ankle joint increases the likelihood of developing a degenerative process in it.
- Weight gain;
- 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, broken ankles and leg bones;
- Constant joint load, which leads to microtrauma (in athletes and people who carry heavy loads);
- Hereditary tendency to joint arthrosis;
- Previous joint inflammation (arthritis) that is infectious or in systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of certain factors that cause this disease, ankle arthrosis can be primary or secondary.There is also a division into levels.If level 1 is present, one can work;if arthrosis has progressed to stage 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle arthrosis
- "Initiate" the pain.This is one of the early symptoms of ankle arthrosis.Pain appears after sitting for a long time when trying to lean on the leg, and may be accompanied by short-term stiffness of movement in the joint.After taking a few steps, the pain disappears;
- Pain during and after physical activity;
- Painful pain at night, it is associated with an inflammatory process triggered by the destruction of cartilage tissue;
- Crunching, clicking in the joints when moving;
- Swelling, especially noticeable below the ankle;
- Limitation of movement;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus is due to the fact that a person begins to save a sore leg;
- Deformation of the joint in the last stage of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its exacerbation from various inflammatory processes in the joints, for example, due to rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes detailed blood tests, rheumatoid tests, tests for CRP, and uric acid.With arthrosis, these indicators are normal, but if the disease is in an acute stage, ESR and leukocytes can increase.To establish the stage of arthrosis and obtain more detailed information about the pathology, radiography in 2 projections, ultrasound, CT or MRI of the joint are used.X-rays may show a slight narrowing of the joint space if the arthrosis is stage 1. When the transition to stage 2 occurs, the joint space is reduced by 40% or more than normal.And in the 3rd stage it narrows significantly, it may be almost absent, bone growth and deformation are visible.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- Unloading the ankle joint during periods of severe exacerbation (walking with crutches on the side of the healthy limb), using bandages;
- Elimination of shock loads (jumping, running), vibration, heavy lifting, long periods of standing;
- Weight control;
- Stop smoking;
- Wearing a semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with intra-articular and periarticular anesthetics to relieve inflammation;
- vascular agent;
- muscle relaxants to eliminate muscle tissue spasms;
- chondroprotectors - drugs administered intra-articularly are more effective.If it is not possible to receive an intra-articular injection, intramuscular administration or oral administration is indicated;
- Hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wearing comfortable shoes with small heels;
- Gymnastics to strengthen the muscle-ligament apparatus.The suggested exercises should be done every day:
- lie down or sit, bend and straighten your toes 10 times;
- lie down or sit, pull your legs towards you and away from you 10 times;
- turn your legs out and in 10 times;
- make circular movements with your legs clockwise and counterclockwise 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 15-20 times.
- Swimming, water aerobics;
- At the 3rd stage of arthrosis and the ineffectiveness of conservative treatment, endoprosthetics of the ankle joint or removal of the destroyed cartilage cover and joint capsule with its closure using a rod structure or Ilizarov device (arthrodesis) is indicated.
Prevention
To reduce the risk of developing arthrosis, priority should be given to foods high in protein 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;
- Controlling body weight;
- You need to stick to a diet, that is, eat more protein-rich foods and refrain from salty, spicy, fried, and alcohol;
- Treat and correct metabolic, endocrine, and vascular diseases in a timely manner;
- Do the above exercise for the ankle joint.
The effectiveness of treatment for deforming arthrosis of the ankle joint depends on the stage of its 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 contact?
If you have pain in the ankle joint, you should consult a rheumatologist.The doctor will prescribe exercise, medication, and identify the cause of the disease.If you have diabetes or gout, it is useful to visit an endocrinologist;if you have atherosclerosis in the vessels of the lower leg, it is useful to visit a vascular surgeon and a cardiologist.The orthopedist plays an important role in the treatment - he will not only help you choose the right shoes and orthopedic insoles, but will 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 physiotherapists.