Deforming osteoarthritis most often affects the joints of the lower limbs, including the ankle.These joints have high mobility in different planes and perform an important function when walking (rolling the foot and transferring weight from heel to toe), and also support the weight of the human body.Osteoarthritis of the ankle joint is a kind of retribution for an 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 it cracks, which triggers the inflammatory process and the growth of bone tissue in the form of osteophytes.With advanced osteoarthritis, a person is unable to move without support and feels severe pain, especially when putting weight on the leg.Disability is possible a few years after the onset of the disease if early and comprehensive treatment is not instituted.
Reasons for the development of the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process.
- Increased body weight;
- Flat feet, congenital foot malformations (cauda foot, club foot);
- 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 foot bones;
- Constant overload of the joint, leading to microtrauma (in athletes and people carrying heavy loads);
- Hereditary predisposition to osteoarthritis of the joints;
- Previous inflammation of the joint (arthritis) of an infectious nature or in the context of systemic diseases (rheumatoid arthritis, psoriatic arthritis, gouty arthritis).
Depending on the absence or presence of a specific factor causing the disease, ankle osteoarthritis can be primary or secondary.There is also a division into stages.If stage 1 is present, a person is able to work;If osteoarthritis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle osteoarthritis
- “Starting” pain.This is one of the first symptoms of ankle osteoarthritis.The pain appears after prolonged sitting when trying to lean on the leg and may be accompanied by short-term stiffness of movement in the joint.After taking a few steps, the pain disappears;
- Pain during and after physical activity;
- Aching pain at night, it is associated with an inflammatory process that is triggered due to the destruction of cartilage tissue;
- Creaking, popping 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 spare the painful 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, due to rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood test, rheumatoid tests, CRP and uric acid test.In case of osteoarthritis, these indicators are normal, but if the disease is in the acute stage, ESR and leukocytes may be increased.To establish the stage of osteoarthritis and obtain more detailed information about the pathology, a 2-projection x-ray, ultrasound, CT scan or MRI of the joint is used.An x-ray may show a slight narrowing of the joint space if the osteoarthritis is stage 1. When moving to stage 2, the joint space is reduced by 40% or more compared to normal.And at the 3rd stage it is significantly narrowed, it may be practically absent, growths and deformations of the bones are visible.
Treatment methods
Osteoarthritis of the ankle joint, like other localizations, requires complex, long-term and progressive treatment.
- Unloading the ankle joint in periods of severe exacerbation (walking with a cane from the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibration, heavy lifting, long periods of standing;
- Body weight control;
- Quit smoking;
- Wearing a semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids combined with intra-articular and periarticular anesthetics to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate muscle tissue spasms;
- chondroprotectors – drugs administered intra-articularly are more effective.If it is not possible to receive intra-articular injections, intramuscular or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wearing comfortable shoes with low heels;
- Gymnastics to strengthen the musculo-ligamentous system.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your feet toward you and away from you 10 times;
- turn your feet outward and inward 10 times;
- make circular movements with your feet clockwise and counterclockwise 10 times;
- sitting in a chair, place your feet on the floor, toes and heels together, alternately move your legs back and forth, repeat 15-20 times.
- Swimming, aquagym;
- At the 3rd stage of osteoarthritis and in case of ineffectiveness of conservative treatment, endoprosthesis of the ankle joint or removal of the destroyed cartilaginous covering and the joint capsule with its closure using a rod structure or Ilizarov apparatus (arthrodesis) are indicated.
Prevention
To reduce the risk of developing osteoarthritis, preference should be given to foods rich in protein in the diet, and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injuries.To do this, you should try not to wear shoes with unstable heels or too hard soles, and use special protective equipment when playing sports;
- Control body weight;
- You need to stick to a diet, that is, eat more protein-rich foods and avoid salty, spicy, fried and alcoholic foods;
- 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 treatment is indicated, it should include medication and physical methods, as well as correction with orthopedic products.
Which doctor should I contact?
If you experience pain in your ankle joint, you should consult a rheumatologist.The doctor will prescribe exercises, medications and identify the cause of the disease.If you suffer from diabetes or gout, it will be useful to consult an endocrinologist;if you suffer from atherosclerosis of the vessels of the lower extremities, it will be useful to consult 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 choose an appropriate diet.Non-drug treatment is carried out with the participation of a physiotherapist.