What is ankle arthrosis?

The ankle joint is often injured because of the heavy load. Such a diagnosis as ankle arthrosis is not uncommon. It is placed regardless of the patient's age and gender. What is ankle arthrosis and how can it be treated?

What it is?

There is a tremendous load on the ankle. Its function is to keep the body upright. Thanks to him, a person walks and runs. With a violation of the ankle system, it is extremely difficult to lead a familiar way of life. What disrupts the work of the ankle?

Ankle arthrosis, what is it? This is a chronic joint disease, which is characterized by a degenerative course. In the cartilage of the joint, irreversible processes are triggered, which lead to formidable complications.

Ankle arthrosis develops gradually. Healthy joint surfaces are elastic and smooth. They provide cushioning under heavy loads and smooth sliding while driving. In pathology, tissue trophism and metabolism are disturbed. The surface of the joint becomes inelastic and rough. During movement, the cartilages come into contact with each other, which leads to inflammation. When lifting weights, the main load falls on the bone, which threatens with degenerative disorders.

Lack of treatment leads to more serious disorders. At 3-4 stages, damage to the cartilage and tissue is observed. The synovium becomes inflamed. The joint becomes unstable. The support function is violated. All these violations in the aggregate lead to the fact that movement becomes impossible.

Arthrosis (osteoarthritis) is one of the most common joint diseases that affects a fairly large number of people.

Causes and risk factors

What is arthrosis of the ankle joint, we have sorted out. Now let's find out what its root cause is. Ankle arthrosis is considered to be a pathology of old age. This is due to age-related changes in the body. Cartilage becomes thinner, bones become unstable and fragile. However, over the past decade, the diagnosis of ankle arthrosis has become much younger. Such statistics are disappointing, since many patients ignore the first signs of the disease. Late diagnosis always threatens the development of serious complications.

The provoking factors include:

• dislocations;
• bruises;
• inflammatory diseases;
• injury;
• excess weight;
• impaired metabolism;
• unbearable physical activity;
• wearing uncomfortable shoes;
• autoimmune and endocrine diseases;
• osteochondrosis.

Clinical symptoms

Ankle arthrosis is recognized by the following features:

1. Pain. It is mild at first and appears after walking or physical exertion. Sometimes when a person is in an uncomfortable position. With the progression of the pathological process, the pain syndrome increases and worries already at rest.
2. Swelling and inflammation. These signs appear against the background of injuries and dislocations. The body temperature in the affected area rises.
3. Click. When the ankle is affected, the click is "dry" and causes an attack of pain.
4. Dislocation or subluxation. Due to the thinning and degradation of cartilage tissue, the joint becomes unstable. Bones can shift and fall out of the joint capsule. These changes cause bouts of acute pain.
5. Joint stiffness. When cartilage tissue is replaced, the bone joint ceases to function normally, which negatively affects its mobility.
6. Joint deformity. The symptom appears at 3-4 stages of arthrosis. Osteophytes also lead to curvature of the ankle.

If one of the symptoms appears, it is recommended to see a doctor immediately. Timely started treatment is a step towards recovery.

Arthrosis of the joints of the foot and ankle is characterized by slow progression with a gradual development of clinical manifestations over several years.

Classification and stages

The disease develops in different ways. In some patients, several years pass from the first signs to the final stage, in others, the rapid development of the disease is observed. The speed depends on the age and state of health of the patient, the time of initiation of therapy. The symptoms of arthrosis of the ankle joint become brighter with the progression of the disease.

There are four stages of arthrosis:

1. The first stage is often unnoticed. Sometimes morning stiffness and ankle pain appear after heavy exertion. When the foot moves, a characteristic crunch is heard. Pathological changes are not yet visible on x-rays, but the destructive process of cartilage has already started.
2. Morning stiffness becomes prolonged. It takes 20-30 minutes to develop a leg. Sometimes lameness occurs. Arthrosis of the 2nd degree of the ankle joint is recognized on the roentgenogram by the growth of bone tissue, displacement of the bones.
3. Symptoms at 3 stages are pronounced. Pain worries no longer only after a heavy load, but also at rest. It is difficult for a patient to do without pain relievers. Lameness increases. Crutches may be needed. The affected joint is swollen and deformed. The ankle muscles atrophy. X-ray shows a narrowing of the joint space, the formation of osteophytes, subluxation.
4. Stage 4 is the most difficult. It develops as a result of lack of treatment. The cartilage is destroyed, the surfaces of the joints are fused. Walking is no longer possible.

With the development of ankle osteoarthritis, there is a gradual change in the cartilage and bone tissue of the articular surfaces.

Diagnostics

Diagnosis of ankle arthrosis is based on clinical symptoms and information obtained during examinations. Laboratory studies are considered ineffective, since there are no special tests that can detect pathology. During the period of remission, all indicators are within normal limits, with an exacerbation of the disease, a clinical blood test will show a high level of C-reactive protein and ESR. These indicators indicate that the pathological process has already started.

To confirm the diagnosis, instrumental methods are used:

• radiograph;
• Magnetic resonance imaging;
• Ultrasound;
• bone scintigraphy;
• diagnostic joint puncture.

Simple radiography

Simple radiography is the most reliable and effective method for diagnosing diseases occurring in the musculoskeletal system. The principle of the manipulation is different absorption of X-rays by muscle tissues. Soft tissues allow X-rays to pass through, but hard tissues absorb. An X-ray allows you to diagnose both the disease itself and its consequences.

Conventional radiography is a method of examination in which a small amount of X-rays are transmitted through the body or part of the body of a person.

The snapshot allows you to see:

1. The condition of the bony surfaces in the articulation.
2. The shape, size and arrangement of structures in the joint are relative to each other.
3. The condition of the fabric.
4. The size of the joint space.

These indicators help the doctor determine the type and extent of joint damage. If the data is not enough, then doctors prescribe other studies.

With arthrosis of the ankle, an X-ray is performed in three projections:

• side;
• back;
• back with a foot moved inward.

The disease is characterized by the following changes:

• reduction of the joint space;
• the presence of osteophytes;
• bone cartilage replacement (subchondral sclerosis);
• minor voids in the periarticular part.

Nuclear magnetic resonance

Nuclear magnetic resonance (NMR) as a diagnostic method allows you to study those parts of the body where there is water. The image shows bones in dark color, because they contain less water, but muscle tissue, discs and nerves are displayed lighter. MRI allows you to detect the slightest changes in the structure of bone tissue and joints. The study is also prescribed to patients before joint prosthetics. YMG has a disadvantage - a high price.

At nuclear magnetic resonance, a change in the properties of hydrogen molecules under the influence of a strong magnetic field is recorded.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is an alternative diagnostic method that allows you to carefully examine the ligamentous structure of the joint, muscle and cartilage tissue. With the help of an MRI, the doctor assesses the condition of the lower leg joints. Based on the survey data, pathology is detected at an early stage of development.

The diagnostic principle is based on exposure to radio waves and strong magnetic radiation. The magnetic field used is not hazardous and does not pose a health hazard.

MRI is contraindicated in case of mental disorders, during pregnancy and in the presence of metal objects in the human body.

When diagnosing arthrosis of the ankle, classical (closed-type) MRI machines are used, since they have better image quality. An MRI machine is a large, cylindrical tube with a magnet around it. The patient lies down on a special table. The ankle is fixed with a special coil. The procedure takes 30-40 minutes. The study is absolutely painless. Patients may feel warmth in the lower leg area.

Ultrasound

Ultrasound examination has been widely used in medicine since the 90s of the twentieth century. This technique has proven itself well in making accurate diagnoses. An ultrasound scan is also performed for arthrosis of the ankle joint.

Today, ultrasound examination is not of particular importance in the diagnosis of osteoarthritis, since it does not allow a sufficiently good study of the damaged joints.

The device with which the study is carried out produces waves at ultrafrequencies. The waves are reflected from the tissues and recorded on the monitor. Based on the resulting image, the doctor determines the type of pathology. To make the image on the monitor clear, a special gel is used. It eliminates air gaps and gives the sensor better glide.

The ultrasound examination does not harm the patient, so the procedure can be repeated many times. The advantages of ultrasound also include low cost and high accuracy.

The following indicators are a clear sign of arthrosis:

• thinning of the cartilage;
• the presence of bone growths;
• accumulation of effusion in the joint cavity (synovitis);
• loss of cartilage space.

Bone scintigraphy

Scintigraphy is a high-precision study that, using isotopes, is able to detect pathological changes in the bones. Doctors divide pathogenic foci into "cold" and "hot". In the first case, we are talking about zones in which there are no isotopes. These areas are poorly supplied with blood, and they are not visible during scanning. "Cold" areas are places that are affected by malignant tumors. In "hot" areas, isotopes quickly accumulate, and they look very bright when scanned. Such areas indicate the presence of inflammatory processes.

The role of scintigraphy in arthrosis is significant. The study helps to distinguish arthrosis from a number of other diseases when the clinical symptoms are extremely similar.

During bone scintigraphy, a special preparation containing special labeled atoms is injected into the body.

Based on the results of scintigraphy, the doctor makes a clinical prognosis and determines the treatment regimen. The only drawback of the study is its high cost. Scintigraphy is performed using special equipment, and, unfortunately, not all medical institutions can afford to purchase it.

Although radioactive scanning is a safe procedure, it still has a number of contraindications:

• pregnancy;
• lactation period;
• taking barium-containing drugs.

When a radioactive substance is injected, some patients experience an allergic reaction in the form of itching and rash. These side effects do not cause dangers and disappear on their own in a short time.

Joint puncture

Joint puncture is a diagnostic procedure in which a needle is inserted into the articular cavity in order to collect synovial fluid. Then this liquid is sent for further research. Based on the data obtained, the doctor makes a conclusion about the nature of the disease and the stage of its development.

At first glance, a puncture is a simple procedure, but it is not. The withdrawal of fluid from the articular capsule requires exceptional accuracy of the doctor's movements. The synovium is very thin and one awkward movement traumatizes it. As a result, an inflammatory process develops. Potential risks also include infection. It is not difficult to bring the infection into the joint capsule through poorly sterilized instruments.

The manipulation technique is different for each joint. When collecting the articular exudate from the ankle, the puncture is made in front, between the external ankle and the tendon of the extensor digitorum longus.

Diagnostic sampling of intra-articular fluid allows laboratory analysis and excludes inflammatory arthritis.

Basic principles of treatment

After confirming the diagnosis of arthrosis of the ankle joint, the symptoms will not be long in coming. Treatment is started immediately. The further prognosis depends on a well-chosen treatment regimen and the timeliness of the start.

Arthrosis is an insidious disease. It cannot be completely cured. The goal of therapy is to stop degenerative processes and prolong the period of remission. For this purpose, doctors prescribe medications, physiotherapy, massage, remedial gymnastics and folk remedies. If all the conditions are met, it is possible to count on positive dynamics, otherwise the disease progresses.

Drug therapy for arthrosis

Depending on the therapeutic effect, drugs are divided into several groups:

1. Anti-inflammatory or pain relievers. This group of drugs is aimed at eliminating the focus of inflammation and relieving pain. The earlier anti-inflammatory therapy is started, the greater the chances of saving the joint. Drugs in this group can be produced in the form of tablets and ointments.
2. Glucocorticoids. These drugs are prescribed when the above means are ineffective. They are produced in the form of a solution for injection. The medicine is injected directly into the joint.
3. Chondroprotectors. Designed to slow down the destruction of cartilage.

The treatment regimen and dosage are selected by the doctor, based on the severity of symptoms, the patient's age, the presence of concomitant diseases and other factors. Self-medication is dangerous and often exacerbates the situation, since many of the drugs have a number of side effects and have their own contraindications.

Features of radical treatment

If conservative therapy fails, then doctors are forced to resort to a radical method of treatment (surgical intervention). The operation is also shown when:

• secondary (post-traumatic) and primary arthrosis of 3-4 degrees;
• arthrosis with complications;
• constant and severe pain in the ankle, radiating to the knee;
• severe lameness;
• paresis and paralysis of the leg muscles;
• violation of the flexion-extensor function of the joint;
• violation of the support ability of the foot.

Surgical intervention is contraindicated in cases where:

• the patient is under 12 years old;
• fistulas are found in the joint;
• the patient has a history of diabetes mellitus, heart failure;
• Infectious diseases were found in the area of the proposed intervention.

Traditional treatment

Doctors believe that the treatment of arthrosis should be carried out exclusively under the supervision of a specialist, but they do not deny the positive effect of folk remedies. Alternative medicine acts as an effective prophylaxis that helps eliminate symptoms and maintain remission.

Folk remedies are rather symptomatic treatment for arthrosis of the foot.

Home treatment should be coordinated with your doctor to avoid side effects and complications.

Traditional healers suggest treating ankle arthrosis with:

1. Burdock. Wash burdock leaves with soap and running water. Apply the leaves with the soft side to your skin. Fix the top with a bandage or cling film. It is better to keep the compress for the whole night.
2. Sea salt. Chop the salt in a skillet. Pour it into a linen bag and attach it to your ankle. Hold the pouch until the salt cools. Heat relieves pain. Sand, lentils, buckwheat are also used instead of salt.
3. Lilacs. Pour the triple cologne over the lilac flowers. Let the tincture stand in a dark and cool place for 10-14 days. Rub the affected area in the morning and evening.
4. Eggshell. Grind the shells in a coffee grinder. Take the resulting powder for ½ tsp. before eating.

Do not forget that treatment with folk remedies should not be the only measure. Complex treatment includes taking medications, exercise therapy, massage, physiotherapy, spa treatment. In advanced cases, doctors resort to radical measures - surgical intervention.

Surgery

For arthrosis of the foot, the following types of operations are used in medicine:

• arthrodesis of the joint;
• arthroscopy of the joint;
• endoprosthetics.

Arthrodesis is an operation to immobilize a joint. It is carried out in order to return the limb of the lost support ability. The only drawback of surgery is that the bones (tibia and talus) grow together, which leads to immobility. Arthrodesis is rarely used in medical practice.

Arthroscopy is a minimally invasive procedure. During the operation, the doctor makes small incisions in the joint area and through them inserts an arthroscope (a special tube at the end of which a camera is installed). With the help of it, the surgeon carefully examines and assesses the condition of the intra-articular structures. If necessary, pieces of the damaged joint or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only drawback of arthroscopy is that the risk of recurrence is too high.

Endoprosthetics is a last resort treatment. It is carried out with advanced arthrosis. Endoprosthetics allows you to replace the affected joint partially or completely. As a prosthetic product, innovative prostheses with modernized mechanics are used. An artificial joint lasts from 10 to 20 years.

Power features

In order to achieve a favorable result, drug treatment is supplemented with diet therapy. Nutritionists have developed a special diet to avoid exacerbation of the disease and at the same time provide the body with all the necessary vitamins and nutrients. The diet for overweight patients plays a special role. Since obesity is one of the reasons for the development of arthrosis, weight correction is an integral part of treatment.

The patient needs to reconsider a number of his habits in everyday life, which contribute to and provoke the progression of arthrosis of the foot.

Nutritionists recommend adhering to the following nutritional conditions:

1. Eat often and in small portions.
2. Drink at least 2 liters of liquid a day.
3. Give up sweets and salt.
4. The last meal is no later than 18. 00.
5. Dishes are allowed to be steamed, boiled or baked.

The main task of the diet for arthrosis is a balanced and fortified nutrition. Fasting is out of the question. Harsh diets and body cleansing do more harm than good. Calcium is flushed out of the body, which is necessary for the restoration of cartilage. A nutritionist will help you compose a daily diet.

With arthrosis, it is allowed to eat cereals, pasta, dairy products, cheese, legumes, vegetables, fruits, rye bread, dried fruits, nuts, fish, poultry meat. Heavy and fatty side dishes, foods containing dyes and flavors, as well as pickles, marinades, smoked meats, fatty broths, baked goods, spices, sauces, chocolate, ice cream, coffee and alcohol are prohibited.

Prevention of arthrosis

In order to avoid the development of arthrosis of the ankle joint, doctors recommend adhering to preventive measures:

• wear comfortable shoes without heels;
• stick to a diet and drink enough fluids;
• seasonally take vitamin and mineral complexes;
• swimming;
• walk more in the fresh air;
• eliminate excessive stress on the legs;
• avoid hypothermia;
• be examined by a doctor in a timely manner.

With existing arthrosis, it is recommended to correct the lifestyle:

1. To refuse from bad habits. It has been proven that they provoke stagnation of blood in tissues and accelerate the destruction of cartilage.
2. Conduct a set of exercises to warm up the ankle.

Forecast

Arthrosis is a progressive disease. Without treatment, it leads to irreversible consequences and complete immobility of the joint. Early diagnosis of pathology allows you to do without radical measures. Medicines are able to suspend the pathological process and alleviate the patient's condition. The fight against the disease in the early stages is without complications.