ankle joint disease

In recent years, experts around the world have noticed an increase in the degenerative malnutrition process of the ankle, which gradually leads to disability. Arthropathy of the ankle joint is usually caused by serious injury or permanent micro-creation of athletes, professional dancers, circus performers. How to spot the signs of this disease and stop it from progressing, and how to treat it, you'll learn from this article.

Ankle disease - what is it

The ankle joint is a complex mass joint formed by the lower (distal) ends of the tibia and fibula of the lower leg, forming the medial and lateral malleolus (ankle) and the talus of the foot. Internally, it is reinforced by the deltoid ligament, and externally - by the anterior and posterior talofibular and calcaneofibular ligaments. Function: flexion and extension of the foot. The ankle is functionally connected to the foot, sharing ligaments and tendons with the joints of the foot.

Arthropathy of the ankle joint is a degenerative dystrophic disease that begins with the thinning and destruction of articular cartilage, reducing its depreciable properties, and subsequently encompassing all other joint tissue in the pathological process. The disease gradually leads to complete wear and tear of the joints and disability. The arthropathy code for ankle ICD-10 is M19.

This disorder is less common than similar knee injuries and is usually the result of a serious or long-term injury from any activity.

Causes of ankle osteoarthritis

Experts study in detail the causes of the development of ankle and foot arthropathy. This:

• Injuries - intra-articular fractures, ankle fractures, complete and incomplete rupture of ligaments and tendons;
• Microtrauma from any professional activity - these are ballet dancers, dancers, professional athletes;
• Increased load on the legs when overweight;
• Improper load distribution when wearing high heels;
• Metabolic disorders that negatively affect cartilage tissue metabolism - diabetes, obesity, gout, etc. ;
• Hormones, including age-related changes;
• Metastasis of severe acute septic arthritis;
• long-term chronic arthritis of any origin;
• Osteochondrosis of the lumbar spine and herniation of the vertebrae, which cause damage to the base of the spine, weakening of the calf and foot muscles, resulting in joint instability and injury.

Mechanisms of disease development (pathogenesis)

Under the influence of various reasons, the blood circulation in the joint area is disturbed, resulting in a decrease in the amount of synovial fluid that feeds the cartilage tissue. Due to the lack of oxygen and nutrients, the cartilage thins and cracks and erosions develop on it. This can lead to damage to the subchondral layer of the bone. It thickens (hardens) and grows along the edges of the joint surface. These growths are called osteophytes. They compress soft tissues, blood vessels and nerves, causing pain and further disrupting blood circulation.

Due to circulatory disturbances and high tone, the muscles are affected, they are weakened, resulting in joint instability and frequent dislocations. Foot arthropathy develops, the facet joints of the tarsus, metatarsal-metatarsal, metatarsophalangeal and interphalangeal joints are affected.

Gradually, connective tissue grows in the joint, tightly binding the joint surfaces and disrupting joint function. Complete loss of ankle function is associated with fusion of the bony joint. Foot joint disease also develops gradually.

Symptoms of Ankle Osteoarthritis

Ankle disease progresses slowly and unnoticed at first. But symptoms gradually appeared and increased, indicating some kind of lower extremity involvement.

first sign

The first symptom of ankle arthropathy is pain during high loads, for example, while walking long distances, dancing, playing football or volleyball, etc. This pain passes quickly, so the person doesn't notice it right away, attributing it to muscle fatigue. Pain in both joints can be either symmetrical (high load and minimally invasive) or unilateral (after severe injury).

Then there is a feeling of stiffness in the morning or after being in a still state for a long time. The ankle can become temporarily stiff, making movement difficult. During the initial phase, it lasts for a few minutes and passes after slow pacing. This symptom should have been alarming and a reason to see a doctor.

obvious symptoms

Gradually, the pain after exertion intensified and lasted longer. Legs hurt all day. Nocturnal pains join in, and they usually appear in the second half of the night, sometimes with painful muscle spasms. Stiffness was also prolonged after immobility.

Due to the severe pain, a person begins to limp while walking, trying to relieve the pain in the foot by stretching or pressing. Sometimes the ankle swells, the skin over it becomes red, and the pain gets worse. This is a sign of synovitis - inflammation of the lining of the synovium. Inflammation is non-infectious in nature, develops from mechanical stimulation, and resolves spontaneously without treatment. But at the same time, the worsening of synovitis activates the progression of the degenerative dystrophic process of the joints.

Dangerous symptoms

Persistent pain, exacerbated by physical exertion, instability, loose joints, tendency to subluxation, dislocations, and ligament damage are dangerous symptoms that require a visit to a doctor. The ankle changes externally: it takes on a different shape due to overgrown osteophytes. The ankle joint (ankle joint) causes it to thicken. Movement of the foot is initially slightly restricted, then the ankle becomes motionless, and vice versa, loose and unstable. But even at this stage, the patient can be helped, you just need to contact the clinic. Symptoms of foot arthropathy appear: foot pain, flexion and depreciation. The development of arthropathy of the big toe is accompanied by pain and deformity of the foot, which manifests as a bulging and bending of the big toe.

What is Dangerous Ankle Disease

The danger is that the disease develops unknowingly at first, and patients often go to the doctor at an advanced stage.

Arthropathy of any location and form has serious complications, so you should not delay treatment.

Classification

Ankle arthropathy can be primary, when the cause of its development has not been identified, or secondary, with a known cause of origin. Depending on the cause of development, the disease may have its own unique characteristics.

Post-traumatic arthropathy of the ankle

The consequences of traumatic injury are the most common causes of the disease. Posttraumatic ankle arthropathy can develop after a severe injury - ligament rupture, dislocation, intra-articular fracture. Usually one joint is injured, so the joint is one side after trauma. Minor but untreated injuries may not be felt at first. Just after a while, when a person has forgotten it, there is a slight pain sensation. This type of injury is dangerous because the patient has gone to the doctor in a state of neglect. Serious injuries are better treated, their consequences appear sooner, and patients don’t seek medical help so late.

Indistinct long-term microtrauma to both ankles is typical for professional dancers, athletes, and people whose occupations are associated with prolonged standing. Symmetrical pain in the ankle occurs during physical activity. They're often mistaken for muscle pain along with fatigue, so it's too late to see a doctor.

ankle joint after arthritis

The cause of these arthropathy may be a chronic inflammatory process (arthritis) in the joints: rheumatoid, reactive, psoriasis. In this case, the inflammatory process is combined with degenerative dystrophy (arthritis-arthritis). This speeds up the destruction process of the ankle. As the inflammation increases, the joints swell, the skin turns red, and the pain becomes very severe, especially at night. When inflammation subsides, metabolic disturbances predominate, while all processes develop rapidly. The disease requires constant monitoring and treatment by a rheumatologist.

The degenerative dystrophic process occurs much less often after acute septic arthritis. The purulent process destroys the tissue of the joint, which, upon recovery, forms connective tissue in its place, disrupting the function of the limb.

Arthropathy can also develop after infectious arthritis - tuberculosis, gonorrhea, etc. The progression of the disease is related to the nature of the primary infectious process and destruction. If the infection persists, joint destruction will progress.

metabolism

Gout has a long course. Many times the first toe is affected. Other small joints of the foot and ankle are less common. Since gout attacks continue, it is difficult to externally determine when the degenerative malnutrition process occurs. You can only see it on X-rays. In any case, the patient should be regularly observed and checked by a rheumatologist.

Ankle deforming joint disease

All types of joints deform over time. Bone deformity indicates an advanced stage of the disease, when the cartilage has collapsed and continued mechanical shock to the bone tissue helps it grow along the edges of the joint surface. This is how osteophytes that change the shape of the joint form.

Degree of arthropathy of the ankle

There are several classifications, one of which distinguishes three clinical and radiological stages of arthropathy:

1. Early. A little soreness after standing or walking for a long time, and some stiffness in the morning. It all goes away quickly without any help. X-ray: The joint space is normal or slightly narrowed.
2. progress. Pain after physical exertion is more intense and lasts longer. Stiffness increases, and joints contract during movement. Sometimes the joint becomes swollen, red, and painful, which is a sign of synovitis. Radiographs show marked narrowing of the joint space, thickening of the subchondral bone tissue (osteosclerosis), and osteophyte growth.
3. final. The pain syndrome intensifies and becomes permanent. Because of the pain, a person can walk with a limp, limp, use crutches or crutches. Limb function is impaired, with foot and thumb joint disease. Complete absence of flexion and extension is rare, usually in the context of arthritis. X-ray: No joint space, osteosclerosis, large osteophytes deform the joint.

possible complications

If the disease is not treated and allowed to run its course, the following complications may occur:

• Persistent joint dysfunction and disability;
• severe persistent pain in the ankle and foot, either after exertion or after exertion;
• Ankle instability with the development of habitual dislocations and subluxations;
• Injuries to the foot and thumb can join, which can further aggravate the patient's condition.

Diagnosis of ankle joint disease

Before prescribing treatment, doctors examine patients, including:

• medical examinations and medical examinations;
• Other research methods: laboratory tests (to detect signs of inflammation and metabolic disorders), instrumental studies (radiography of joints in two projections, computer and magnetic resonance imaging - to detect early changes in bone structure and soft tissue), diagnosticArthroscopy (inspecting internal joint surfaces).

Treatment of ankle joint disease

After a final diagnosis is made, the doctor chooses an individualized treatment plan for the patient, including both pharmacological and non-pharmacological approaches.

Drug therapy for ankle osteoarthritis

Medications are prescribed for both symptomatic (elimination of disease symptoms) and pathogenic (inhibition of disease development mechanisms).

Anti-inflammatory and pain relievers

To eliminate pain, medications called non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed for a short period of time, and they work well to relieve pain and inflammation (if synovitis worsens):

• injection;
• rectal suppositories;
• oral tablet;
• skin patch.

muscle relaxant

The muscles around the affected joint and in the movement are constantly tense, causing them to atrophy and increase pain. To eliminate muscle spasms, drugs of the muscle relaxant group are prescribed.

chondroprotective agent

Drugs from the group of chondroprotectants contain glucosamine or chondroitin, and sometimes both. They protect chondrocytes from damage and promote their recovery. They are prescribed in the form of injections, tablets, and topical preparations (creams and ointments).

Hyaluronic acid preparation for ankle joint disease

To improve the buffering capacity of synovial fluid and prevent further damage to cartilage and bone tissue, hyaluronic acid is injected into the joint cavity. This relieves pain and improves joint mobility.

Anti-arthritic gels and ointments for ankle joint disease

External means can be used at home. Ointment for ankle joint disease:

• NSAID gel for pain relief and inflammation;
• Restoring Cartilage - Chondroitin-based gels and ointments.

non-drug treatment

The mainstay of treatment for ankle disease is non-drug therapy. These are therapeutic exercises, massage, physiotherapy, wearing orthopaedic devices.

physiotherapy

To relieve the patient's condition and restore joint function, specify:

• drug electrophoresis;
• Laser Treatment;
• magnetic therapy;
• Temperature program - paraffin, ozokerite, in resort conditions - mud application.

Ankle Osteoarthritis Massage

Massage sessions improve blood circulation, which activates metabolism and restores joints and extra-articular tissues. The positive effects of massage on the muscles are the elimination of spasms, which aids blood flow to the muscles, and restores muscle strength, which is necessary to keep the limb in the desired position.

Exercise and Exercise Therapy for Ankle Arthropathy

Therapeutic gymnastics is a panacea for joint disease. Physical activity is important, and in addition to exercise therapy, swimming can also be useful. Systematic implementation of doctor-chosen exercises can allow you to restore the function of your limbs to a large extent, even with advanced disease.

A set of approximate exercises (but you will need to consult your doctor before you start implementing them):

Use of Special Orthopedic Products

To prevent the disease from progressing, your doctor may prescribe the wearing of special orthopedic devices - orthoses. It fixes the leg in the correct anatomical position, relieves muscle tension and improves blood circulation. Wearing orthoses is prescribed by a doctor, who will also choose the most suitable model.

Ankle fixation can also be done with tape: Using special tape, the ankle is lightly fastened in the desired position.

operation treatment

Surgery is recommended for severe pain that cannot be eliminated by conservative treatments and for severe limb dysfunction.

Types of Surgical Interventions

Operation can be done in traditional and gentle ways:

1. Therapeutic arthroscopy (sparing surgery):
   • Hygiene of the joint cavity - with the help of arthroscopy, fragments of cartilage and bone tissue are removed from the joint cavity, which interfere with movement and cause pain;
   • Chondroplasty - removal of damaged layers of cartilage to stimulate the growth of new cartilage cells (abrasive chondroplasty); in some cases, autologous cartilage slices taken from the unloaded area of the patient's knee joint are transplanted (mosaic arthroplasty)); chondroplasty is effective in the second stage of the disease, when the joint has not yet lost function.
2. Arthrodesis is a traditional surgical procedure. It is performed with severe violations of limb function, loosening, habitual dislocation and pain. The joint is removed, and the bones of the lower leg are fused with the bones of the foot. The ankle becomes motionless and serves only as support.
3. An endoprosthesis is the replacement of a worn and nonfunctional ankle joint with an artificial prosthesis.

Post-operative rehabilitation features

All operations are carried out under stationary conditions, after which a full restoration is recommended by experts. With back-up surgery, rehabilitation is performed on an outpatient basis, and in addition to high loads on the joints, early on is included in the course of therapeutic exercises. After the prosthesis is implanted, the patient stays in the hospital for a week and then undergoes rehabilitation measures in the outpatient clinic. After two weeks, the stitches are removed and the patient can take a bath.

diet food

There is no special diet for osteoarthritis. But to remove unnecessary stress from your ankles, it's essential to maintain a normal weight. A person should get proper healthy nutrition, but the bulk of high-calorie foods should be replaced in part with vegetables and fruits. Low-fat first and second courses, chicken, sea fish, cottage cheese, cheese, and dairy are all useful.

traditional medicine

Conventional medicine alone will not help. But they can be used as part of a complex treatment prescribed by a doctor. Here are some recipes:

• Oral: wild rosemary infusion; pour 20 grams of chopped grass into a thermos bottle with 500 ml of boiling water overnight, filter in the morning, take half a cup 4 times a day for a month; analgesia, restore cartilage tissue;
• Oral administration: Take a mummy ball with a diameter of 0. 5 cm in the morning, chew it thoroughly, 30 minutes before meals, and take it continuously for 10 days; rest for 5 days, and then repeat 3 times; an excellent stimulant for the metabolic process;
• Honey massage: Apply warm honey liquid to the ankle before going to bed, rub it gently, massage the tissue for 5 minutes; then wrap the leg with a warm shawl until morning; restore the blood circulation and metabolism of the cartilage tissue.

Treatment in the clinic

Clinicians have developed their own methods to treat conditions such as ankle and foot arthropathy. During the initial appointment, the patient is thoroughly examined, and the doctor listens carefully to his complaints and medical history, after which he prescribes additional laboratory and instrumental studies, including an MRI. Only after this can the doctor determine the final diagnosis, prescribe and agree with the patient on complex treatment. it includes:

• Modern programmes of pharmacological and non-pharmacological treatment of arthropathy - drugs, physiotherapy, exercise therapy and massage, methods of ankle immobilization;
• Traditional methods of oriental therapy - acupuncture, moxibustion, acupressure, various kinesiotherapy methods, including sticking.

These are not all methods used by clinics. Physicians are able to combine Eastern and Western approaches to significantly accelerate patient improvement. Patients quickly got rid of pain and their quality of life improved significantly.

Combining proven Eastern techniques with innovative approaches to Western medicine.

Prevent foot joint disease

To reduce the risk of disease progression, the following recommendations should be followed:

• Activities, exercise therapy, swimming should be a part of your life;
• High physical activity and any trauma factors should be excluded; trekking should be combined with rest, and if a leg is injured at work, it is worth replacing;
• Injuries should be ruled out by thinking about exercise patterns and shoes used, especially on ice in winter;
• Reasonable nutrition is necessary to restore metabolism, but being overweight is an extra burden on the ankle, get rid of it;
• Preventive therapy courses are the guarantee of a pain-free life.

Frequently Asked Questions about Disease

1. Which doctor should I contact for ankle osteoarthritis and foot arthropathy?

   to an orthopedic surgeon. But if the disease develops in the context of some rheumatic process, then see a rheumatologist.

2. What predictions do doctors usually give?

   It is possible to stop the progression of the degenerative process and improve the quality of life at any stage, but it is best to do so at the onset of the disease and not wait for complications to appear.

3. Can ankle osteoarthritis develop in children?

   Perhaps after injury or in the context of congenital pathology.

4. What are the consequences of the disease?

   Untreated joint disease can lead to disability. If you start treatment on time, there is a good chance that the function of the limb will be preserved. Later treatment will reduce pain and improve quality of life.

5. Are sports injuries the cause of ankle osteoarthritis?

   Yes, sports injuries are one of the main causes of this disease.

6. Can Ankle Tapes Be Used for Arthropathy?

   It is possible, but this should be done by an expert.

Arthropathy of the ankle is almost always the result of major or microtrauma. At first it was slow and imperceptible. Therefore, prompt treatment and rehabilitation after an injury is very important, as well as contacting a doctor at the first signs of ankle disease.