Osteoarthritis of the ankle joint: Degenerative-dystrophic damage to the cartilage tissue. But since as the disease progresses, the articular surfaces of the bones become involved in the process, it is more correct to call it osteoarthritis. In foreign literature, when describing this disease, the term osteoarthritis is used, which indicates not only degenerative changes, but also inflammation in this context.
Osteoarthritis: This is a chronic and progressive joint disease in which cartilage, the articular surfaces of the bones, the capsule and periarticular tissues are destroyed. This causes pain and joint mobility problems. The ankle rarely suffers from osteoarthritis, unlike the knee. The disease occurs more frequently in women over 50 years of age and in athletes who have suffered foot injuries. For osteoarthritis of the ankle joint, treatment depends on the manifestations of the disease and is selected individually by an orthopedic traumatologist. Doctors use methods that have been proven effective and safe and practice a multidisciplinary approach to treat the problem and prevent the progression of joint pathology.
This article is advisory in nature. The treatment is prescribed by a specialist after consultation.
How the disease develops
The ankle joint is made up of three bones: the tibia, the fibula and the talus, covered by a joint capsule and reinforced by ligaments. Thanks to the work of the muscles, the foot bends and extends. Normally, joint surfaces are smooth and slide easily over each other during movements. Covered by dense and elastic cartilage, its main function: bone protection and load absorption. The joint cavity contains synovial fluid. It plays the role of intra-articular lubrication, preventing friction of the joint elements and their abrasion during movements.
But as a result of injury or natural aging of the joint, the joint surfaces become rough and the cartilage tissue loses its smoothness and elasticity. When the cartilage is damaged and as degenerative changes progress, the bones begin to come into contact with each other as they move in the joint, which is accompanied by pain.
In an attempt to "defend" and to compensate for further damage to the joint and surrounding tissues, osteophytes form; Growth along the edges of the articular surfaces of bones. As a result, the mobility of the joint is partially or even completely limited.
Depending on the root cause, the following types of osteoarthritis are distinguished:
- Primary or idiopathic osteoarthritis. In this case we are talking about degenerative-dystrophic changes in the joint.
- Secondary is associated with exposure to a specific causal factor, generally a previous joint injury. And this form is diagnosed most often.
Predisposing factors
The main predisposing factors for the development of osteoarthritis of the ankle joint:
- Intra- and peri-articular injuries, such as bone fractures, tears and ligament ruptures.
- ankle surgery
- inflammatory joint injuries in the past
- intense loads: professional sports, ballet, long walks, jobs associated with long periods of "standing"
- sedentary lifestyle
- wear high heels for a long time
- overweight
- hereditary collagenopathies leading to impaired collagen synthesis
- Chronic injury to joint structures due to excessive loads.
- Metabolic disorders: diabetes, gout.
- estrogen deficiency in postmenopausal women
- rheumatic diseases
- foot deformities, such as flat feet
- degenerative-dystrophic changes in the spine, complicated by the formation of an intervertebral hernia, which is accompanied by compression of the nerve root
Ankle osteoarthritis: symptoms.
The main sign of osteoarthritis: Pain is what makes you seek help from a doctor. At the beginning of the development of the disease, the pain bothers only after prolonged exercise and decreases with rest.
Depending on the stage of pathological changes in the joint, the pain becomes more intense and persists at rest and even at night. Other symptoms occur.
There are three stages of the disease:
- The first stage is characterized by slight swelling, redness of the skin in the joint area, pain during the day or after intense exercise. Unpleasant sensations are localized along the front surface of the foot, along the joint line and are transferred to the lateral surfaces of the ankle. The foot x-ray may not yet show any changes.
- In the second stage, the pain becomes constant, a crunch appears when moving the joint, mobility is limited and the joint "locks". When examined on an x-ray, growths are noted along the edges of the articular surfaces of the bones: tibia, ankles and talus, as well as a narrowing of the joint space.
- In the third stage, the joint is deformed, so that only oscillating and low-amplitude movements are possible. The x-ray reveals massive bone growths, the joint space is greatly narrowed or even absent. Due to the instability of the joint, patients often twist their leg, which only aggravates the situation due to sprains, ligament tears and deterioration in general condition.
Pain with ankle osteoarthritis has characteristic features:
- Maximum expressed at the beginning of the movement: the so-called initial pain
- It increases significantly with load, especially when running, jumping.
- It often appears in the evening, at night, or immediately after waking up.
Due to the pain, limited mobility of the foot occurs, as well as binding in the joint as the cartilage is destroyed.
Symptoms appear in waves: exacerbations alternate with remissions. With an exacerbation, the symptoms are more pronounced. During remission, symptoms gradually disappear and may even disappear completely.
Which doctor should I contact?
If pain and stiffness occur in ankle movements, an orthopedic traumatologist should be consulted. If another cause of joint discomfort is identified, a consultation with a neurologist, rheumatologist, or endocrinologist may be necessary.
Diagnosis
To make a diagnosis, the doctor clarifies the complaints, specifies how long the pain has been observed, what contributes to its appearance and intensification. The specialist collects data on existing diseases, injuries and lifestyle characteristics, performs an examination, evaluates the range of motion of the joint and performs diagnostic tests.
Already on the basis of the information received, it is possible to assume the diagnosis, but to confirm it and draw up a competent treatment plan, additional examination methods are needed, which may include:
- X-ray of the ankle joint, which is of primary importance in making a diagnosis and determining the stage of development of the disease. The images show narrowing of the joint space, osteophytes at the edges of the joint surfaces of the bones, cysts, and signs of thinning of the bone beneath the cartilage.
- A CT scan of the joint reflects the image in more detail. The doctor can evaluate in detail the condition of the patient's bone structures and cartilage tissue.
- MRI is used to study cartilage and soft tissues.
- Ultrasound of the joint to evaluate the condition of soft joint structures.
Osteoarthritis treatment
Treatment of pathology is long-term and is carried out under the supervision of an orthopedic traumatologist on an outpatient basis. The way to cure osteoarthritis of the leg depends on the stage of the damage and the existing complications.
The main goals of treating the disease in a modern clinic are to relieve pain in the legs, improve the patient's quality of life and slow down the progression of osteoarthritis. To do this, the doctor develops a set of therapeutic and preventive measures, medicinal and non-medicinal, and also adjusts the patient's lifestyle.
Correction of lifestyle and nutrition.
Sufficient physical activity and nutritional correction will help stop degenerative changes. After the examination, the clinic's doctors can give recommendations for losing weight, as well as optimizing the load on the legs.
Pharmacotherapy
Medicines are selected individually, based on examination data, symptoms and concomitant diseases. The patient may be prescribed:
- Analgesics. In most cases these are non-steroidal anti-inflammatory drugs in the form of tablets, gels and injections to relieve pain and inflammation.
- Antidepressants and anticonvulsants for prolonged, intense, and difficult-to-treat pain.
exercise therapy
Specially selected exercises help maintain joint range of motion, reduce pain, and slow the progression of degenerative changes. The patient performs the recommended exercises at first under the supervision of a specialist and then during the day. home alone.
Massage
Massage of the lower extremities normalizes the nutrition of the joint tissues. It is prescribed outside the acute phase. During the session, the specialist performs passive movements in the joint, which prevents muscle shortening and joint stiffness.
Assistive devices
Special orthoses, canes, and walkers may be recommended to relieve stress and stabilize the ankle joint.
Surgery
It is used only in cases of severe destruction of articular cartilage and limited joint mobility. After the operation there is a long period of rehabilitation and conservative treatment. Endoprosthesis or arthroplasty in the later stages of the development of ankle osteoarthritis; Practically the only opportunity to avoid disability and maintain joint mobility.
Why is ankle osteoarthritis dangerous?
The changes already formed in the joint are irreversible. Therefore, treatment aims to slow down the pathological process to preserve the patient's working capacity and quality of life. It is possible to achieve such goals only with timely treatment and strict adherence to the doctor's recommendations.
As osteoarthritis develops, a pronounced deformation of the joint forms. The range of motion decreases sharply, as a result, the ability to hold the foot becomes difficult, walking without crutches or a cane is almost impossible.
Chronic and constant pain in the joints causes anxiety and depressive disorders.
Prevention
Prevention of osteoarthritis includes the following measures:
- Avoid traumatic activities. For example, jumping from great heights, running
- Avoid injuries
- Be careful in icy conditions, wear non-slip shoes.
- Control your body weight
- Normalizing body weight will help reduce stress on the ankle joint.
- Stay moderately active
- A sedentary lifestyle is dangerous and causes complications, as well as excessive overload and microtrauma.
- Keep your joints healthy
- Consult a doctor promptly and treat musculoskeletal diseases.
Main points of the article:
- The prevalence of degenerative-dystrophic diseases of the foot joints is 87%.
- Occupational hazards, daily habits, and past injuries can cause osteoarthritis of the ankle joint.
- A common symptom of osteoarthritis: pain, which is accompanied by a crunch when moving, local swelling, and subsequently limited mobility of the foot
- Treatment of ankle osteoarthritis is usually conservative and includes both medicinal and non-medicinal methods.
- The progression of ankle osteoarthritis leads to disability and complete loss of foot function.