What is ankle arthrosis?

The ankle joint is often damaged by heavy loads. A diagnosis such as ankle arthrosis is not uncommon. Placed regardless of the age and sex of the patient. What is ankle arthrosis and how can it be treated?

What is this?

There is a very large load on the ankle. It is to keep the position upright. Thanks to him, a person walks and runs. It is extremely difficult to lead a lifestyle familiar with ankle disorders. What disrupts the work of the ankle?

Ankle arthrosis, what is it? It is a chronic joint disease characterized by a degenerative course. In the joint cartilage, irreversible processes are triggered, which leads to serious complications.

Ankle arthrosis develops gradually. Healthy joint surfaces are elastic and smooth. Provides cushioning under heavy loads and smooth sliding while driving. With pathology, tissue trophism and metabolism are impaired. The surface of the joint is not elastic and rough. During movement, the cartilage comes into contact with each other, which causes inflammation. When lifting weights, the main load falls on the bone, which threatens degenerative disorders.

Lack of treatment leads to more serious disorders. In stages 3-4, cartilage and tissue damage is observed. The synovium becomes inflamed. The joint becomes unstable. The support function is impaired. All these violations make the movement impossible.

Osteoarthritis is one of the most common joint diseases affecting quite a few people.

Causes and risk factors

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

Irritants include:

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

Clinical symptoms

Ankle arthrosis is characterized by the following features:

1. Pain. It is mild at first and appears after walking or physical exertion. Sometimes when a person is in a state of anxiety. As the pathological process progresses, the pain syndrome intensifies and is already at rest.
2. Swelling and inflammation. These symptoms appear against the background of injury and dislocation. Body temperature rises in the affected area.
3. Click. When the ankle is affected, the click "dries" and causes an attack of pain.
4. Dislocation or subluxation. The joint becomes unstable due to the thinning and fragmentation of cartilage tissue. Bones can slip and fall from the joint capsule. These changes cause severe pain.
5. Joint stiffness. When cartilage tissue is altered, the bone joint stops functioning normally, which negatively affects its mobility.
6. Joint deformation. The symptom appears in stages 3-4 of osteoarthritis. Osteophytes also cause ankle curvature.

If any of the symptoms appear, it is recommended to consult a doctor immediately. Timely treatment is a step towards recovery.

Osteoarthritis of the feet and ankles is characterized by a slow progression with the gradual development of clinical manifestations over several years.

Classification and stages

The disease develops in different ways. In some patients, it takes several years from the first symptoms to the final stage, while in others, the disease progresses rapidly. The speed depends on the patient's age and health status, the time of starting treatment. Symptoms of osteoarthritis of the ankle joint become more pronounced as the disease progresses.

There are four stages of osteoarthritis:

1. The first stage is often overlooked. Occasionally there is morning stiffness and ankle pain after severe stiffness. When the foot moves, a characteristic crisis is heard. Pathological changes are not yet visible on X-rays, but the destructive process of cartilage has already begun.
2. Stretches in the morning stiffness. The development of one foot takes 20-30 minutes. Sometimes stupidity arises. Grade 2 arthrosis of the ankle joint is characterized by enlargement of bone tissue and bone displacement on the radiograph.
3. Symptoms are pronounced in 3 stages. The pain is not only after a heavy load, but also at rest. It is difficult for a patient to do this without painkillers. Eldership is on the rise. Gloves may be needed. The affected joint swells and deforms. Atrophy of the ankle muscles. X-ray shows narrowing of the joint space, the formation of osteophytes, subluxation.
4. Stage 4 is the most difficult. It develops as a result of untreated. Cartilage is destroyed, the surfaces of the joints are melted. It is no longer possible to walk.

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

Diagnostics

The diagnosis of ankle arthrosis is based on clinical symptoms and examination data. Laboratory tests are considered ineffective because there are no specific tests to detect pathology. During remission, all indicators are normal, and with exacerbation of the disease, a clinical blood test will show high levels of C-reactive protein and ESR. These indicators indicate that the pathological process has already begun.

Instrumental methods are used to confirm the diagnosis:

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

Simple radiography

Simple radiography is the most reliable and effective method for diagnosing diseases of the musculoskeletal system. The principle of manipulation is that X-rays are absorbed differently by muscle tissue. Soft tissues allow X-rays to pass through, but hard tissues are absorbed. An X-ray allows you to determine both the disease itself and its consequences.

Conventional radiography is a method of examination in which small amounts of X-rays pass through the body or part of the body.

Lets see the picture:

1. Condition of bone surfaces in articulation.
2. The shape, size and arrangement of the 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 to determine the type and degree of joint injury. If the information is not enough, doctors prescribe other tests.

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

• yan;
• back;
• moved his foot backwards, inwards.

The disease is characterized by the following changes:

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

Nuclear magnetic resonance

Nuclear magnetic resonance imaging (NMR) is a diagnostic method that allows the body to study where water is present. The picture shows dark bones because it contains less water, but the muscle tissue, discs and nerves look lighter. MRI allows you to detect the smallest changes in the structure of bone tissue and joints. Research is also prescribed to patients before joint prosthesis. YMG has one drawback - high price.

Changes in the properties of hydrogen molecules are recorded under the influence of a strong magnetic field in nuclear magnetic resonance.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is an alternative diagnostic method that allows careful examination of the ligament structure of joints, muscles and cartilage tissue. With the help of MRI, the doctor assesses the condition of the lower leg joints. According to the survey, it occurs at an early stage of pathological development.

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

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

Classical (closed type) MRI machines are used to diagnose arthrosis of the ankle because of its better image quality. An MRI device is a large, cylindrical tube with a magnet around it. The patient lies on a special table. The ankle is fixed with a special roll. The procedure takes 30-40 minutes. The research is completely painless. Patients may feel heat in the lower leg area.

Ultrasound

Ultrasound has been widely used in medicine since the 1990s. This technique has proven to be effective in making accurate diagnoses. Ultrasound examination is also performed for arthrosis of the ankle joint.

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

The device emits waves in ultraviolet light. The waves are reflected from the tissues and recorded on a monitor. Based on the image, the doctor determines the type of pathology. A special gel is used to make the image on the monitor clear. Eliminates air gaps and ensures better sliding of the sensor.

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

The following indicators are a clear sign of osteoarthritis:

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

Bone scintigraphy

Scintigraphy is a high-precision study that can detect pathological changes in bones using isotopes. Doctors distinguish pathogenic foci as "cold" and "hot". In the first case, we are talking about zones without isotopes. These areas are poorly supplied with blood and are not visible during the scan. "Cold" areas are areas affected by malignant tumors. In "hot" areas, isotopes accumulate quickly and appear very bright when scanned. Such areas indicate the presence of inflammatory processes.

The role of scintigraphy in osteoarthritis is great. Research helps to differentiate osteoarthritis from a number of other diseases when the clinical symptoms are extremely similar.

During bone scintigraphy, a special drug with specially labeled atoms is injected into the body.

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

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

• pregnancy;
• lactation period;
• to take drugs containing barium.

When a radioactive substance is injected, some patients experience an allergic reaction in the form of itching and rash. These side effects are not dangerous 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 joint cavity to collect synovial fluid. This fluid is then sent for investigation. Based on the information received, the doctor draws a conclusion about the nature and stage of development of the disease.

At first glance, a puncture is a simple procedure, but it is not. Withdrawal of fluid from the joint capsule requires exceptional precision of the doctor's actions. The synovium is very thin and an awkward movement damages it. As a result, an inflammatory process develops. Potential risks include infections. It is not difficult to inject the infection into the joint capsule using poorly sterilized instruments.

Manipulation techniques are different for each joint. When collecting articular exudate from the ankle, the puncture is performed between the anterior ankle and the tendon of the extensor digitorum longus.

A diagnostic sample of intraarticular 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 wait long. Treatment begins immediately. The additional prognosis depends on the correctly chosen treatment regimen and the time of onset.

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

Drug treatment for osteoarthritis

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

1. Anti-inflammatory or analgesic. This group of drugs aims to eliminate the center of inflammation and relieve pain. The sooner anti-inflammatory therapy is started, the better 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 drugs are ineffective. Produced in the form of a solution for injection. The drug is injected directly into the joint.
3. Chondroprotectors. Developed to slow cartilage destruction

The treatment regimen and dose 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 aggravates the situation, because many drugs have a number of side effects and have their own contraindications.

Features of radical treatment

If conservative therapy fails, doctors are forced to resort to a radical method of treatment (surgery). The operation is displayed at the same time:

• secondary (post-traumatic) and 3-4 degree primary osteoarthritis;
• osteoarthritis with complications;
• constant and severe pain in the ankle, spread to the knee;
• severe lameness;
• paresis and paralysis of the leg muscles;
• impairment of flexion-extensor function of the joint;
• impairment of the foot's ability to support.

Surgery is contraindicated in the following cases:

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

Traditional treatment

Doctors believe that the treatment of osteoarthritis can be carried out only under the supervision of a specialist, but do not deny the positive effects of folk remedies. Alternative medicine plays an effective prophylactic role in helping to relieve symptoms and maintain remission.

Folk remedies for osteoarthritis of the feet are very symptomatic.

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

Traditional doctors offer treatment for ankle arthrosis:

1. Burdock. Wash the burdock leaves with soap and running water. Apply to the skin with the soft side of the leaves. Cover with bandage or adhesive film. It is better to keep the compress all night.
2. Sea salt. Chop the salt in a pan. Pour into a linen bag and stick to your ankle. Keep the bag until the salt cools. Eliminates heat painsInstead of salt, sand, lentils and buckwheat are also used.
3. Lilacs. Pour triple cologne over lilac flowers. Tincture should stand 10–14 days in a dark and cool place. Rub the affected area in the morning and evening.
4. Eggshell. Chop the peels in a coffee grinder. Take the resulting powder ½ for a teaspoon. before meals.

Remember that treatment with folk remedies should not be the only measure. Complex treatment includes medication, exercise therapy, massage, physiotherapy, spa treatment. In advanced cases, doctors resort to radical measures - surgery.

Surgery

The following types of surgery are used in medicine for osteoarthritis of the foot:

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

Arthrodesis is an operation to immobilize a joint. It is performed to regain a limb of lost support ability. The only disadvantage of the operation 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 inserts their arthroscope (a special tube with a camera installed at the end). With its help, the surgeon carefully examines and evaluates the condition of the intraarticular structures. If necessary, damaged joint fragments or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only disadvantage of arthroscopy is the very high risk of recurrence.

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

Power features

Drug treatment is supplemented with diet therapy to achieve a favorable result. Dietitians have developed a special diet to prevent the disease from getting worse and at the same time provide the body with all the necessary vitamins and nutrients. Diet plays a special role for overweight patients. Because obesity is one of the causes of osteoarthritis, weight correction is an integral part of treatment.

The patient should reconsider a number of habits in daily life that contribute to and stimulate the development of osteoarthritis of the foot.

Dietitians recommend the following dietary conditions.

1. Eat often and in small portions.
2. Drink at least 2 liters of fluid a day.
3. Avoid sweets and salt.
4. Last meal no later than 18. 00.
5. Food is allowed to be steamed, boiled or cooked.

The main task of the diet for osteoarthritis is a balanced and enhanced diet. There is no question of fasting. Strict diets and body cleansing do more harm than good. Calcium is eliminated from the body, which is necessary for the regeneration of cartilage. A nutritionist will help you plan your daily diet.

Osteoarthritis is allowed to eat grains, pasta, dairy products, cheese, legumes, vegetables, fruits, rye bread, dried fruits, nuts, fish, poultry. Foods with heavy and fatty garnishes, 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 osteoarthritis

To prevent the development of osteoarthritis of the ankle joint, doctors recommend taking preventive measures:

• wear comfortable shoes without heels;
• follow a diet and drink enough fluids;
• take vitamin and mineral complexes seasonally;
• swimming;
• walk more in the fresh air;
• eliminate excessive stress on the legs;
• avoid hypothermia;
• Get a timely medical examination.

It is recommended to correct the lifestyle with existing osteoarthritis:

1. To give up bad habits. They have been shown to cause blood stasis in tissues and accelerate the destruction of cartilage.
2. Do a series of exercises to warm up your ankles.

Forecast

Osteoarthritis 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. Medications can stop the pathological process and alleviate the patient's condition. The fight against the disease at an early stage is without complications.