MedClinic > Blog > Traumatology > Ankle arthrosis

The term “ankle joint arthrosis” means a disease in which gradual destruction of the articular cartilage occurs, followed by involvement of bones of the joint and its ligaments and muscles in the deforming process. The disease most often develops in the elderly, has specific symptoms.

The main reasons for the development of ankle arthrosis are several:

1) Constant increased load on the joint. This is typical for athletes: swimmers, runners, soccer players, ballerinas.

2) Overweight.

3) Joint injuries: foot strains (for example, on ice), fractures of ankles, sprains, microtraumas of the muscles surrounding joints.

4) Continuous walking in high heels (more than 1/5 of the foot length).

5) Hereditary metabolic dysfunction in the articular cartilage, due to which its resistance to stress is reduced.

6) Inflammation in the joint, for example, with rheumatoid arthritis or gout.

7) Diseases in which the metabolism is disturbed (including in articular cartilage);

8) Diabetes mellitus;

9) Thyroid diseases;

10) Gout.

11) Disruption of blood supply to the joint due to atherosclerosis, thrombosis or sclerosis of the vessels that feed it. Under the influence of etiological factors in the cartilage lining of the joint bones, metabolism is impaired, and it becomes thinner, and this does not happen immediately on the entire surface, but in parts. It does not recover. In those areas where the cartilage has become thinner, the load is no longer on it, but on the underlying bone. As a result, the bone also grows in islets, forming spikes – osteophytes. They injure adjacent and opposite areas of the articular cartilage, and it is also damaged. The joint is deformed. Ligaments and muscles, trying to return to a normal position, are cramped on the one hand, and overstretched on the other.

The main symptoms are:

In order not to miss the development of the disease, it is necessary to know the early signs of arthrosis. And so, arthrosis of the ankle joint is characterized by pain in the affected joint, which can occur after rest, in the morning, aggravated by exertion, as well as symptoms such as

  • crunching, clicks in the joint;
  • stiffness of the joint;
  • fatigue when walking due to pain;
  • due to weakening of muscles and ligaments, habitual joint subluxation may occur;
  • visual deformation of joint.

Symptoms of ankle joint arthrosis develop gradually, so the degenerative process in a joint is divided into several stages:

1) Initially, there are no symptoms. Then they appear: foot fatigue with previous physical exertion, including walking in heels; discomfort at first, then – pain in the joint, which appears during foot movements, disappears at rest or when the joint is fixed with bandages or orthoses; no crunching or other sounds are heard during movements in the joint.

2) Pain in the joint occurs even with less stress. For it to disappear, one needs a long rest. Pain can also occur at night, due to which a person wakes up. In the morning, the joint almost does not function for some time, and then it passes. Ankle reacts to the weather.

3) This is an extreme degree of severity of the degenerative process in the joint. After a night, the joint has to be developed for a long time to allow the minimum range of motion to take place in it. When the joint is working, crunching, clicking is heard in it. Pain during movement of the ankle is severe, does not go away after rest, it is necessary to take painkillers.

Treatment of ankle arthrosis

With arthrosis of the ankle joint, conservative and surgical treatment is used, the choice depends on the stage of the disease. Conservative treatment should be carried out in a complex and consists of drug treatment, exercise therapy, physiotherapy, additional treatment methods. Let’s consider them in order. As drug therapy such medications are used:

1) Drugs that relieve pain and relieve inflammation: Diclofenac, Indomethacin, Nimesulide. If at the first stage of arthrosis medications can also be used in the form of ointments or gels, then already at the second stage it is necessary to use them in the form of tablets or injections.

2) Chondroprotectors: “Dona”, “Structum”, “Arthra.” The action of these drugs is aimed at maintaining the structural integrity of the remaining cartilage. These are prescribed only at stages 1-2 of the disease for at least six months.

3) To improve joint nutrition, vascular medications are used: “Niacin”, “Trental”.

4) To stop pain and inflammation, hormones (Diprospan) can be injected several times into the joint.

5) Hyaluronic acid agents are very effective – analogues of the natural lubrication of the joint.

Intra-articular drug administration

Exercise therapy

A set of exercises is selected individually, depending on the stage of the process and individual tolerance to load. When performing the training program, there should be no pain, but slight discomfort should be felt.

Exercise therapy and physiotherapy of the ankle joint

Physiotherapy

The following types of procedures are used: magnet therapy; phonophoresis; laser therapy; diadynamic therapy; thermal procedures; massage.

Surgery

It is used only in advanced stages. With arthrosis of the ankle joint, the following types of surgical interventions are performed:

  • Arthroscopy: the introduction of a special endoscopic equipment into the joint cavity, with which bone growths, necrotic cartilage are removed. The surfaces of the articulating bones are aligned.
  • Arthrodesis – creation of an artificial union between the articulating surfaces of the ankle joint (locking the joint).
  • Replacing a damaged joint with an endoprosthesis.