Osteoarthritis of the ankle joint – degenerative-dystrophic damage to cartilage tissue. However, as the disease progresses, the articular surfaces of the bones become involved in the process, so it is more correct to speak of osteoarthritis. In foreign literature, when describing this disease, the term arthrosis is used, which denotes not only degenerative changes, but also, against this background, inflammation.
Osteoarthritis – This is a chronic, progressive joint disease in which cartilage, articular surfaces of bones, capsule and periarticular tissue are destroyed. This leads to pain and limited joint mobility. In contrast to the knee, osteoarthritis rarely occurs in the ankle joint. The condition is more common in women over 50 and in athletes who have suffered foot injuries. In the case of osteoarthritis of the ankle, treatment depends on the severity of the disease and is selected individually by an orthopedic traumatologist. Doctors use methods proven to be effective and safe and take a multidisciplinary approach to treating the problem and preventing the progression of joint pathology.
This article is advisory in nature. The treatment is prescribed after consultation by a specialist.
How the disease develops
The ankle joint consists of three bones: tibia, fibula and talus, which are covered by a joint capsule and reinforced by ligaments. Thanks to muscle work, the foot is flexed and extended. Normally, the articular surfaces are smooth and slide easily relative to each other during movements. Its main function is dense, elastic cartilage. Bone protection and load bearing. The joint cavity contains synovial fluid. It serves for intra-articular lubrication and prevents friction of the joint elements and their abrasion during movements.
However, due to injuries or natural aging of the joint, the joint surfaces become rough and the cartilage tissue loses its smoothness and elasticity. With cartilage damage and progressive degenerative changes, the bones begin to come into contact with each other during movements in the joint, which is accompanied by pain.
In attempts to "defense" and compensate for further damage to the joint and surrounding tissues, osteophytes are formed. 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 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 a previous joint injury. And this form is the most commonly diagnosed
Predisposing factors
The main predisposing factors for the development of ankle arthrosis:
- intra- and periarticular injuries such as bone fractures, tears and ligament tears
- Ankle surgery
- inflammatory joint lesions in the past
- intense stress: professional sports, ballet, long walking, work that involves being on your feet for a long time
- sedentary lifestyle
- I wear high heels for a long time
- Overweight
- hereditary collagenopathies that lead to impaired collagen synthesis
- chronic injury to joint structures due to excessive stress
- 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
Osteoarthritis of the ankle joint: symptoms
The main sign of osteoarthritis – pain is the reason why you see a doctor. At the beginning of the disease's development, the pain is only bothersome after prolonged exertion and subsides with rest.
Depending on the stage of the pathological changes in the joint, the pain increases 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 physical activity. Unpleasant sensations are localized along the front surface of the foot, along the joint line and migrate to the lateral surfaces of the ankle. The x-ray of the foot 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 "stucks". X-ray examination reveals growths on the edges of the articular surfaces of the bones: tibia, ankle and talus, as well as narrowingof the joint space
- In the third stage, the joint deforms, which is why only rocking movements with a low amplitude are possible. The X-ray shows massive bone growths, the joint space is severely narrowed or even missing. Due to the instability of the joint, patients often twist their leg, which only aggravates the situation due to sprains, torn ligaments and a deterioration in general condition
Pain in ankle osteoarthritis has characteristic features:
- Maximum expression at the beginning of the movement – so-called start-up pain
- Increases significantly with strain, especially when running and jumping
- Often occurs in the evening, at night or immediately after waking up
Due to the pain, the foot's mobility is restricted and the joint becomes jammed due to the destruction of the cartilage.
The symptoms manifest themselves in waves: exacerbations alternate with remissions. During an exacerbation, the symptoms are more pronounced. During remission, symptoms gradually subside and may even disappear completely.
Which doctor should I contact?
If pain and stiffness occur in the movements of the ankle joint, you should consult an orthopedic traumatologist. If another cause of joint discomfort is identified, consultation with a neurologist, rheumatologist or endocrinologist may be necessary.
diagnosis
To make a diagnosis, the doctor clarifies the complaints, indicates how long the pain was observed, what contributes to its occurrence and intensification. The specialist collects data on existing diseases, injuries and lifestyle features, conducts an examination, assesses the range of motion in the joint and conducts diagnostic examinations.
A diagnosis can be made based on the information received. However, to confirm them and draw up a competent treatment plan, additional examination methods are required, which may include:
- X-ray of the ankle joint, which is of utmost importance for diagnosing and determining the stage of development of the disease. The images show narrowing of the joint space, osteophytes on the edges of the articular surfaces of the bones, cysts and signs of bone thinning under the cartilage
- A CT scan of the joint shows the picture in more detail. The doctor can assess in detail the condition of the patient's bone structures and cartilage tissue
- MRI is used to examine cartilage and soft tissue
- Ultrasound of the joint to assess the condition of soft joint structures
Treatment of osteoarthritis
Treatment of pathology is long-term and is carried out on an outpatient basis under the supervision of an orthopedic traumatologist. How osteoarthritis of the leg can be cured 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 leg pain, improve the patient's quality of life and slow down the progression of arthrosis. For this purpose, the doctor develops a set of therapeutic and preventive medical and non-medical measures, and also adjusts the patient's lifestyle.
Correction of lifestyle and diet
Adequate physical activity and dietary correction help curb degenerative changes. After the examination, the clinic's doctors can give recommendations for weight loss and optimizing the load on the legs.
Medication
The medication is selected individually based on examination data, symptoms and comorbidities. The patient may be prescribed:
- Analgesics. Most often these are non-steroidal anti-inflammatory drugs in the form of tablets, gels and injections to relieve pain and inflammation
- Antidepressants and anticonvulsants for persistent, severe and difficult-to-treat pain
Movement therapy
Specially selected exercises help maintain joint mobility, relieve pain and curb the progression of degenerative changes. The patient performs the recommended exercises first under the supervision of a specialist, and then - alone, at home.
massage
Massage of the lower limbs normalizes the nutrition of the joint tissues. It is prescribed outside the acute stage. During the session, the specialist performs passive movements in the joint, which prevents muscle shortening and joint stiffness.
Auxiliary devices
Special orthoses, canes and walking aids can be recommended to relieve and stabilize the ankle joint.
surgery
It is only used in cases of severe destruction of the articular cartilage and limited joint mobility. After the operation there is a long rehabilitation and conservative treatment phase. Endoprosthetics or arthroplasty in the later stages of the development of ankle arthrosis - practically the only way to avoid disability and maintain joint mobility.
Why is ankle osteoarthritis dangerous?
Changes that have already occurred in the joint are irreversible. Therefore, treatment is aimed at slowing down the pathological process in order to preserve the patient's ability to work and quality of life. These goals can only be achieved through timely treatment and strict adherence to the doctor's recommendations.
With the development of osteoarthritis, a pronounced deformation of the joint occurs. The range of motion decreases significantly, making it more difficult to support the foot and walking without crutches or a cane is almost impossible.
Chronic, persistent pain in the joint leads to anxiety and depressive disorders.
prevention
Prevention of osteoarthritis includes the following measures:
- Avoid traumatic activities. For example, jumping from a height, running
- Avoid injuries
- Use caution in icy conditions and wear non-slip shoes
- Control your body weight
- Normalizing body weight helps reduce stress on the ankle joint
- Stay moderately active
- An inactive lifestyle is dangerous and leads to complications, as well as excessive overwork and microtrauma
- Keep your joints healthy
- See a doctor immediately and treat any musculoskeletal disorders
Main points of the article:
- The prevalence of degenerative-dystrophic diseases of the ankle joints is 87%
- Occupational hazards, everyday habits, and previous injuries can lead to ankle osteoarthritis.
- A common symptom of osteoarthritis – pain accompanied by a crunching sound when moving, local swelling and later limited mobility of the foot
- The treatment of ankle osteoarthritis is often conservative and includes both medicinal and non-medicinal methods.
- Progression of ankle osteoarthritis leads to disability and complete loss of foot function