Deformed arthritis most often affects the joints of the lower legs, one of which is the ankle. These joints have great mobility in different planes and perform important functions while walking (rolling the foot and transferring weight from heel to foot), as well as bearing human weight. Arthrosis of the ankle joint is a kind of retaliation for walking upright. But many other factors play a role in the development of the disease. First, invisibly to the patient, softening and thinning of the cartilage 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 arthrosis, a person is unable to move without support and experiences severe pain, especially when leaning on the foot. Defects are possible in a few years after the onset of the disease, if early and comprehensive treatment is not initiated.
Causes of disease development
Previous injuries to the ankle joint increase the likelihood of degenerative processes developing in it.
- Weight gain;
- Flat feet, congenital deformities of the feet (horse feet, club feet);
- Metabolic disorders in diseases such as diabetes mellitus, gout, atherosclerosis of the foot passages;
- Past joint injuries, for example, damage to the ligament apparatus, fractures of the ankle and leg bones;
- Persistent joint overload, leading to microtraumatization (in athletes and people carrying heavy loads);
- Hereditary predisposition to joint arthrosis;
- Previous joint inflammation (arthritis) that is contagious or with systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of certain factors causing the disease, ankle arthrosis can be primary or secondary. There is also a division into stages. With the presence of stage 1, a person is able to work, if the arthrosis has progressed to stage 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of osteoarthritis of the ankle
- "Starting" pain. This is one of the early symptoms of osteoarthritis of the ankle joint. Pain appears after prolonged sitting when trying to lean on the legs, may be accompanied by short -term movement stiffness in the joints. After taking a few steps, the pain disappeared;
- Pain during and after physical exercise;
- Night pain pain, it is associated with inflammatory processes triggered by the destruction of cartilage tissue;
- Crunch, click on joints during movement;
- Swelling, especially noticeable below the ankle;
- Restriction of movement;
- Periarticular muscle hypotrophy and weakness of the ligament apparatus is due to the fact that a person begins to save a sore leg;
- Joint deformity in the last stages of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its exacerbation from various inflammatory processes in the joints, for example, as a result of gouty rheumatoid or psoriatic arthritis. Therefore, doctors prescribe detailed blood tests, rheumatoid tests, tests for CRP, uric acid. With arthrosis, this indicator is normal, but if the disease is in the acute stage, ESR and leukocytes may 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 is used. On x-ray, a slight narrowing of the joint space may be observed if the arthrosis is in the first stage. During the transition to stage 2, joint space is reduced by 40% or more from the norm. And in the 3rd stage, it narrows significantly, it can be practically absent, bone growth and deformation are visible.
Methods of Treatment
Arthrosis of the ankle joint, as well as other localizations, involves complex, long -term and course treatment.
- Unloading the ankle joint during periods of severe exacerbation (walking with a cane on the side of a healthy limb), use of bandages;
- Exclusion of shock loads (jumping, running), vibration, weight transfer, prolonged stay on the legs;
- Weight control;
- To quit smoking;
- Wearing a semi -rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Medical therapy:
- NSAIDs externally, orally, in injection;
- glucocorticoids along with intraarticular and periarticular anesthetics to relieve inflammation;
- vascular agents;
- muscle relaxants to relieve muscle tissue spasms;
- chondroprotectors are more effective drugs given intraarticularly. If it is not possible to receive intra-articular injections, intramuscular administration, oral administration is indicated;
- hyaluronic acid preparations to restore synovial fluid quality.
- Orthopedic insoles, wear comfortable shoes with small heels;
- Gymnastics to strengthen the musculoskeletal system. The following exercises need to be done daily:
- lie down or sit, bend and release your toes 10 times;
- lie down or sit, pull your legs towards you and away from you 10 times;
- turn the leg out and in 10 times;
- make circular movements with the feet clockwise and counterclockwise 10 times;
- sit on a chair, place your feet on the floor with your toes and heels together, rearrange your feet forward and backward alternately, repeat 15-20 times.
- Swimming, water aerobics;
- In stage 3 arthrosis and ineffectiveness of conservative treatment, replacement of the ankle joint endoprosthesis or removal of the destroyed cartilage coating and joint capsule with its closure with the help of a rod structure or Ilizarov tool (arthrodesis) is indicated.
Prevention
To reduce the risk of developing arthrosis, foods should be given priority to foods high in protein, and spicy, salty, fried and alcoholic foods should be excluded from the diet.
- Avoid injury to the joints. To do this, you must try not to wear shoes with unstable heels, soles too hard, use special protective equipment while playing sports;
- Weight control;
- You need to stick to a diet, that is, eat more foods rich in protein, and refrain from salty, spicy, fried, alcoholic;
- Treat and correct metabolic disorders, endocrine, vascular diseases in a timely manner;
- Perform the above exercises for the ankle joint.
The effectiveness of treatment of deformed arthrosis of the ankle joint depends on its stage of development and the presence of concomitant diseases. In any case, if conservative therapy 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 exercise, medications, and identify the cause of the illness. In case of diabetes or gout, it is useful to visit an endocrinologist, in case of atherosclerosis of the lower extremities - vascular surgeons and cardiologists. The orthopedic specialist plays an important role in the treatment - he or she will not only help you choose the right shoes, orthopedic insole, but also perform surgery 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.