Deforming osteoarthritis most frequently 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 weight of the body 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 upright posture.But many other factors also play a certain role in the development of the disease.First, without the patient noticing, the cartilage covering 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 osteoarthritis, a person cannot move without support and experiences severe pain, especially when leaning 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 of developing a degenerative process in it.
- Increase in body weight;
- Flat feet, congenital foot deformities (cauda foot, clubfoot);
- Metabolic disorders in diseases such as diabetes, gout, atherosclerosis of the blood vessels of the legs;
- Previous joint injuries, for example, damage to the ligamentous apparatus, fractures of the ankles and bones of the foot;
- Constant overload of the joint, which causes microtrauma (in athletes and people who carry heavy loads);
- Hereditary predisposition to osteoarthritis of the joints;
- Previous inflammation of the joint (arthritis) of an infectious nature or in systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of a specific factor that caused the disease, ankle osteoarthritis can be primary or secondary.There is also a division into stages.If stage 1 is present, the person can work;If osteoarthritis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle osteoarthritis.
- "Initial" pain.This is one of the first symptoms of ankle osteoarthritis.The pain occurs after sitting for a long time when trying to lean on the leg and may be accompanied by brief 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 that is triggered by the destruction of cartilage tissue;
- Creaks, clicking in the joint when moving;
- Swelling, especially noticeable below the ankles;
- Limitation of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that a person begins to heal the sore leg;
- Joint deformation in the last stage of osteoarthritis.
Diagnosis
It is necessary to distinguish osteoarthritis 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 CRP test and uric acid.In osteoarthritis, these indicators are normal, but if the disease is in an acute stage, ESR and leukocytes may increase.To establish the stage of osteoarthritis and obtain more detailed information about the pathology, radiography in 2 projections, ultrasound, computed tomography or magnetic resonance imaging of the joint is used.An x-ray may show a slight narrowing of the joint space if osteoarthritis is in stage 1. Moving to the second stage, the joint space is reduced by 40% or more than normal.And in the third stage it narrows significantly, it can be practically absent, growths and deformations of the bones are seen.
Treatment methods
Osteoarthritis of the ankle joint, like other locations, requires complex, prolonged and continuous treatment.
- Unloading the ankle joint during a period of severe exacerbation (walking with a cane on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibrations, heavy lifting, long periods of standing;
- Body weight control;
- Quit smoking;
- Using 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 anesthetics intra-articularly and peri-articularly to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate muscle tissue spasm;
- Chondroprotectors: medications administered intra-articularly are more effective.If intra-articular injections are not possible, intramuscular administration or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, comfortable shoes with small heels;
- Gymnastics to strengthen the musculoligamentous apparatus.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your feet towards you and away from you 10 times;
- turn your feet out and in 10 times;
- make circular movements with your feet clockwise and counterclockwise 10 times;
- Sitting on a chair, place your feet on the floor with your toes and heels together, move your legs alternately back and forth, repeat 15 to 20 times.
- Swimming, water aerobics;
- In the third stage of osteoarthritis and the ineffectiveness of conservative treatment, endoprosthesis of the ankle joint or removal of the destroyed cartilage and the joint capsule with its closure using a rod structure or an Ilizarov apparatus (arthrodesis) is indicated.
Prevention
To reduce the risk of developing osteoarthritis, preference should be given to protein-rich foods in the diet, and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injuries.To do this, it is necessary to try not to wear shoes with unstable heels or too hard soles, and to use special protective equipment when playing sports;
- Control body weight;
- It is necessary to follow a diet, that is, eat more foods rich in protein and refrain from salty, spicy, fried foods and alcohol;
- Timely treat and correct metabolic disorders, endocrine and vascular diseases;
- Perform the above exercises for the ankle joints.
The effectiveness of treatment of deforming osteoarthritis 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 medications 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 exercises, medications and identify the cause of the disease.If you have diabetes or gout, it will be helpful to visit an endocrinologist;If you have atherosclerosis of the vessels of the lower extremities, 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 will also perform surgery if necessary.If you are overweight, you should be examined by a nutritionist and select appropriate nutrition.Non-drug treatment is carried out with the participation of a physiotherapist.