Osteoarthritis of the ankle joint -degenerative-dystrophic damage to the cartilaginous tissue. But since as the disease progresses, the articular surfaces of the bones are involved in the process, it is more correct to talk about osteoarthritis. In foreign literature, to describe this disease, the term osteoarthritis is used, which indicates not only degenerative changes, but also inflammation in this context.
Osteoarthritis -This is a chronic, progressive joint disease in which cartilage, joint surfaces of bones, capsules and periarticular tissues are destroyed. This leads to pain and reduced joint mobility. The ankle rarely suffers from osteoarthritis, unlike the knee. The disease occurs more often in women over 50 and in athletes who have suffered foot injuries. For ankle osteoarthritis, treatment depends on the manifestations of the disease and is selected individually by an orthopedic traumatologist. Doctors use methods that have proven their effectiveness and safety and practice a multidisciplinary approach to treat the problem and prevent the progression of joint pathology.
This article is advisory in nature. Treatment is prescribed by a specialist after consultation.
How the disease develops
The ankle joint is made up of three bones: the tibia, fibula and talus, covered by a joint capsule and reinforced by ligaments. Thanks to the work of the muscles, the foot bends and extends. Normally, the joint surfaces are smooth and slide easily past each other during movement. Covered with dense and elastic cartilage, its main function: protection of bones and absorption of loads. 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 softness and elasticity. When the cartilage is damaged and degenerative changes progress, the bones begin to come into contact with each other during movements in the joint, which is accompanied by pain.
In an attempt to "defend" and compensate for additional 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 causative factor, usually prior joint injury. And this form is most often diagnosed
Predisposing factors
The main predisposing factors for the development of ankle osteoarthritis:
- intra- and periarticular injuries, such as bone fractures, ligament tears and ruptures
- ankle surgery
- inflammatory joint damage in the past
- intense loads: professional sports, ballet, long walks, work associated with long periods of "standing"
- sedentary lifestyle
- wear high heels for a long time
- overweight
- hereditary collagenopathies leading to impaired collagen synthesis
- chronic damage 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, accompanied by compression of the nerve root
Osteoarthritis of the ankle: symptoms
The main sign of osteoarthritis -Pain is what makes you seek help from a doctor. Early in the course of the disease, the pain is only bothersome after prolonged exercise and diminishes 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 appear.
There are three stages of the disease:
- The first stage is characterized by slight swelling, redness of the skin in the joint area, pain in the afternoon or after intense exercise. Unpleasant sensations are localized along the front side of the foot, along the joint line and move to the lateral surfaces of the ankle. The foot x-ray may still show no 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 along the edges of the articular surfaces of the bones are visible: shin, ankles and talus, as well as a narrowing of the joint space.
- In the third stage, the joint is deformed, which is why only small amplitude rocking movements are possible. The x-ray reveals massive bony 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 associated with ankle osteoarthritis has characteristics:
- Maximum expressed at the start of movement — what we call initial pain
- Significantly increases with load, especially when running, jumping
- Often appears in the evening, at night or immediately after waking up
Due to the pain, mobility of the foot is limited, as well as locking of the joint as the cartilage is destroyed.
Symptoms appear in waves: exacerbations alternate with remissions. In case of exacerbation, the symptoms are more pronounced. During remission, symptoms gradually ease and may even disappear completely.
Which doctor should I contact?
If there is pain and stiffness in ankle movements, you should consult an orthopedic traumatologist. If another cause of joint discomfort is identified, a consultation with a neurologist, rheumatologist or endocrinologist may be necessary.
Diagnostic
To make a diagnosis, the doctor clarifies the complaints, specifies how long the pain has been observed, which contributes to its appearance and intensification. The specialist collects data on existing diseases, injuries and lifestyle features, conducts an examination, assesses the range of motion of the joint and conducts diagnostic tests.
Already based on the information received, it is possible to assume a diagnosis, but to confirm it and develop 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 assess 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 assess the condition of soft joint structures
Treatment of osteoarthritis
The treatment of the pathology is long-term and is carried out under the supervision of an orthopedic traumatologist on an outpatient basis. How to cure osteoarthritis of the leg depends on the stage of the lesion and the existing complications.
The main goals of treating the disease in a modern clinic are to relieve leg pain, 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 curb degenerative changes. After the examination, doctors at the clinic can give recommendations on weight loss as well as optimizing the load on the legs.
Medical treatment
Medicines are selected individually, based on examination data, symptoms and concomitant diseases. The patient may be prescribed:
- Painkillers. These are most often nonsteroidal anti-inflammatory drugs in the form of tablets, gels, injections to relieve pain and inflammation.
- Antidepressants and anticonvulsants for prolonged, severe, difficult-to-treat pain
Exercise therapy
Specially selected exercises help maintain the range of motion of the joint, reduce pain and slow the progression of degenerative changes. The patient first performs the recommended exercises under the supervision of a specialist, and then -alone, at home.
Massage
Massage of the lower limb normalizes the nutrition of the joint tissues. It is prescribed outside the acute stage. During the session, the specialist performs passive movements at the joint, which prevents muscle shortening and joint stiffness.
Assistive devices
Special orthotics, canes, and walkers may be recommended to relieve stress and stabilize the ankle joint.
Surgery
It is only used 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. Endoprostheses or arthroplasty at later stages of development of ankle osteoarthritis -practically the only opportunity to avoid disability and maintain joint mobility.
Why is ankle osteoarthritis dangerous?
Changes already formed in the joint are irreversible. Treatment therefore aims to slow down the pathological process in order to preserve the patient's work 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 deformity of the joint is formed. The range of motion decreases sharply, making the ability to support the foot difficult, walking without crutches or a cane is almost impossible.
Chronic and constant joint pain leads to anxiety and depressive disorders.
Prevention
Prevention of osteoarthritis includes the following measures:
- Avoid traumatic activities. For example, jumping very high, running
- Avoid injury
- Be careful in icy conditions, wear non-slip shoes
- Control your weight
- Normalization of body weight will help reduce stress on the ankle joint
- Stay moderately active
- An inactive lifestyle is dangerous and leads to complications, as well as excessive overload and microtrauma.
- Keep your joints healthy
- See a doctor promptly and treat musculoskeletal diseases
Main points of the article:
- The prevalence of degenerative-dystrophic diseases of the joints of the foot is 87%
- Occupational hazards, daily habits and previous injuries can lead to osteoarthritis of the ankle joint.
- A common symptom of osteoarthritis -pain, which is accompanied by a crunch when moving, local swelling and, later, limited mobility of the foot
- Treatment of ankle osteoarthritis is often conservative and includes medicinal and non-drug methods.
- Progression of ankle osteoarthritis leads to disability and complete loss of foot function