Ankle arthrosis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Ankle arthrosis symptoms
- Diagnostics
- Ankle arthrosis treatment
- Possible complications and consequences
- Forecast
- Prevention
Arthrosis of the ankle joint is a chronic degenerative-dystrophic disease in which the articular cartilage is first affected, and then the joint capsule, synovial membrane, ligaments with adjacent muscles and bones are gradually involved in the pathological process. With the progression of the disease, irreversible changes occur in the ankle joint, which can cause serious consequences. The disease affects both women and men. The likelihood of arthrosis of the ankle joint increases with age, most often (about 80% of the total number of patients) the disease is diagnosed in elderly patients.
Damaged ankle joint with arthrosis
The ankle joint connects the peroneal, tibial and talus bones, that is, it is the articulation of the leg with the foot. In it, movements such as flexion and extension of the foot, its adduction and abduction are possible. Normally, the articular surfaces are smooth and elastic, they perform a shock-absorbing function under load. As a result of degenerative processes, the surface of the cartilage becomes rough, which additionally injures the cartilage when rubbing with each other and aggravates pathological changes in the cartilage. A vicious circle is forming. At the same time, the load on the bone surface increases, the bone grows along the edges of the articular platform, and bone protrusions (osteophytes) can form in the articular space. The ankle capsule and synovium thicken, and foci of fibrous tissue form in the ligaments and muscles. Contractures appear in the joint,movements in it are limited, and in the later stages of the disease they stop completely. When the joint is destroyed, the support function of the lower limb is impaired.
Causes and risk factors
Arthrosis of the ankle joint occurs when the balance between the processes of degeneration and regeneration of the joint cartilage tissue is disturbed, which occurs when the blood supply to the joint deteriorates and metabolic processes are disturbed in its tissues. Primary arthrosis occurs in the absence of any previous pathologies, secondary arthrosis develops against the background of other diseases or injuries of the ankle joint.
Wearing uncomfortable, tight heeled shoes can cause arthrosis of the ankle
The main risk factors for the development of the disease are:
- ankle injuries (ligament ruptures and tears, ankle or talus fractures);
- excessive stress on the ankle joint (intense sports, long walking, working conditions associated with a long stay in an upright position);
- uneven distribution of the load on the legs during movement;
- frequent microtrauma of the joint;
- wearing high-heeled shoes, tight, uncomfortable shoes;
- pathological conditions that are accompanied by disturbances in the work of the muscular apparatus of the lower leg and foot, as well as pinching of the nerves;
- surgical interventions on the ankle joint;
- metabolic disorders;
- overweight;
- rheumatic diseases;
- hereditary predisposition;
- unfavorable ecological situation;
- elderly age.
Forms of the disease
As mentioned above, arthrosis of the ankle joint can be primary or secondary. There are also post-traumatic and deforming arthrosis.
Disease stages
During arthrosis of the ankle joint, three stages are distinguished, specified by means of hardware diagnostics:
- Pathological changes are practically not noticeable, there may be a thickening of the talus, narrowing of the ankle joint gap.
- The consequence of the progression of the inflammatory process is swelling, the mobility of the lower limb decreases, the appearance of pain is associated with a change in the weather, and deformation of the joint is noted.
- Ossification of cartilage tissue occurs, loss of the amortization properties of the joint, deformation of the foot leads to disability.
Ankle arthrosis symptoms
Ankle arthrosis is characterized by a chronic course with periodic exacerbations followed by remission. During remissions, complete recovery does not occur; joint destruction gradually progresses.
The first symptoms of ankle arthrosis are leg fatigue and mild pain in the ankle area.
Symptoms of arthrosis of the ankle joint in the initial stage are poorly expressed, for a long time the pathology can develop without showing itself. The first signs are increased leg fatigue, the appearance of moderate pain in the ankle, at first with significant, and later with moderate physical exertion. With the progression of the disease, pain becomes more pronounced, pain occurs not only after exertion, but also at rest, including at night. Gradually, the deformity of the joint becomes visible, the range of motion in the ankle joint decreases, the movements are accompanied by crunching, squeaking, and clicking. In some cases, the legs are bent, while the legs acquire an X-shaped (valgus) or O-shaped (varus) shape. For arthrosis of the ankle joint, the so-called starting pains are characteristic,which appear at the beginning of movements after a state of rest and gradually disappear in the process of movement, patients designate them as the need to disperse.
In the later stages of arthrosis, instability of the ankle joint is observed, which can cause tears and sprains.
Joint instability can cause sprains and tears of the ligaments, frequent twisting of the leg when walking. Such injuries can cause inflammation, increasing joint destruction. In the future, the functions of the joint are increasingly limited, support on the affected limb becomes difficult, while the patient is forced to use a cane or crutches when walking, the pain becomes constant.
Diagnostics
The diagnosis is made on the basis of the data obtained during the collection of complaints and anamnesis, an objective examination of the patient, as well as instrumental examination.
In order to clarify the diagnosis and determine the stage of the disease, they resort to X-ray of the ankle joint. The presence of arthrosis is indicated by a narrowing of the joint space, overgrowth of the edges of the bones that form the surface of the joint, an increase in bone density of the bone located under the cartilage (subchondral).
CT and MRI of the ankle joint allows diagnosing arthrosis and its degree
In some cases, to confirm the diagnosis, it may be necessary to conduct computed tomography of the ankle joint, which allows a more detailed assessment of the state of its bone structures, as well as magnetic resonance imaging, which makes it possible to examine soft tissues in the affected area.
Ankle arthrosis treatment
Treatment of arthrosis of the ankle joint is complex and, as a rule, long-term. Usually, patients are treated on an outpatient basis, however, during exacerbations, hospitalization in an orthopedic hospital may be required.
Drug therapy is selected taking into account the stage of the disease, as well as the severity of symptoms. During exacerbations of arthrosis of the ankle joint, nonsteroidal anti-inflammatory drugs and analgesics in the form of an ointment or gel for topical use are prescribed, in case of severe pain, intra-articular administration of corticosteroid drugs is used (this procedure can be carried out no more than 4 times throughout the year), which have a pronounced analgesic and anti-inflammatory effect.
Chondroprotectors can be used, which are believed to contribute to the restoration of cartilage tissue and the normalization of metabolic processes in it. However, it should be noted that this group of drugs belongs to drugs with unproven action - in the course of a number of tests, it was not possible to confirm their any serious effect on the articular cartilage.
A good therapeutic effect for arthrosis of the ankle is achieved with regular use of exercise therapy
Treatment of arthrosis of the ankle joint is complemented by physiotherapy, magnetotherapy, laser therapy, ultra-high-frequency therapy, electrophoresis, phonophoresis, as well as mud therapy, hydrogen sulfide and radon baths are used.
Massage for arthrosis of the ankle joint has a relaxing effect, improves peripheral circulation, prevents muscle atrophy and the development of contractures. After training by a specialist, it is possible to conduct regular self-massage sessions.
Modification of the patient's lifestyle, including the correct regimen of physical activity, is of key importance in slowing the progression of the pathological process. For this reason, the patient is given recommendations for reducing excess weight, if necessary, and a complex of therapeutic exercises is prescribed. When choosing exercises for arthrosis of the ankle joint, the clinical picture and stage of the disease, as well as the individual characteristics of the patient, are taken into account. The set of exercises is selected by the doctor and carried out under his supervision.
In the absence of a positive effect from conservative therapy, especially in the later stages of the disease, they resort to surgical methods of treating arthrosis of the ankle joint. These include:
- sanitation arthroscopy of the ankle joint (fragments of cartilage, osteophytes and other formations are removed from the articular cavity using an arthroscope);
- arthrodesis of the ankle joint (removal of the joint and fusion of the bones that form the ankle joint);
- endoprosthetics (removal of a destroyed joint followed by its replacement with a high-tech implant).
Possible complications and consequences
Arthrosis of the ankle joint leads to the destruction of joint components, articular deformity, partial or complete atrophy of nearby muscles, decreased mobility of the lower limb and, as a result, disability of the patient.
Forecast
At the first stage of the disease, with timely diagnosis and a correctly selected therapy regimen, the prognosis is favorable, and a complete cure is possible. In the second stage, irreversible changes already occur, but adequate treatment helps prevent further joint destruction and loss of its functions. At the third stage of arthrosis, the prognosis for recovery is negative; significant deformation of the joint, leading to the loss of its functions, can be eliminated only by endoprosthetics. Lack of necessary treatment leads to disability.
Prevention
To prevent the development of arthrosis of the ankle joint, it is recommended:
- timely treatment of diseases that can lead to arthrosis of the ankle joint;
- prevention of lower extremity injuries;
- correction of excess weight;
- balanced diet;
- rejection of bad habits;
- selection of high quality, comfortable shoes.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
