ankle arthritis

Ankle Arthritis – Degenerative dystrophic damage to cartilage tissue. But because as the disease progresses, the articular surfaces of the bones become involved, it is more correctly called osteoarthritis. In foreign literature, when describing this disease, the term osteoarthritis is used, which denotes not only degenerative changes, but also inflammation in this context.Osteoarthritis – This is a chronic progressive joint disease in which cartilage, bone articular surfaces, joint capsules, and periarticular tissues are destroyed. This can lead to pain and impaired joint mobility. Unlike the knee, osteoarthritis rarely occurs in the ankle. The disease is more common in women over 50 and athletes who have suffered foot injuries. For arthropathy of the ankle joint, treatment depends on the manifestations of the disease and is chosen individually by the orthopedic traumatologist. Doctors use methods that have proven effectiveness and safety and employ a multidisciplinary approach to treat the problem and prevent the progression of joint pathology.This article is advisory in nature. Treatment is prescribed in consultation with a specialist.

How the disease develops

The ankle joint is made up of three bones: the tibia, fibula, and talus, which are covered by a joint capsule and reinforced by ligaments. The foot can flex and extend due to the work of the muscles. Typically, joint surfaces are smooth and tend to slide relative to each other during movement. Covered by dense, elastic cartilage, whose main function is bone protection and load absorption. The joint cavity contains synovial fluid. It acts as lubrication within the joint and prevents friction and wear of joint components during movement.
However, due to joint injury or natural aging, the joint surface becomes rough and the cartilage tissue loses smoothness and elasticity. When cartilage is damaged and degenerative changes progress, the bones begin to contact each other as they move within the joint, causing pain.
In an attempt to "defend" to compensate for further damage to the joint and surrounding tissue, osteophytes form - growths along the edges of the articular surfaces of bones. As a result, the joint's mobility is partially or even completely limited.Depending on the underlying cause, osteoarthritis can be divided into the following types:

1. Primary or idiopathic osteoarthritis. In this case, we are talking about degenerative dystrophic changes in the joints
2. Secondary is related to exposure to a specific causative agent, usually a previous joint injury. This form is most commonly diagnosed

Predisposing factors

The main predisposing factors for ankle joint arthrosis:

• Intra- and periarticular injuries, such as fractures, tears, and ligament ruptures
• ankle surgery
• Past inflammatory joint disease
• High-intensity loads: professional sports, ballet, long walks, work involving long periods of "standing"
• sedentary lifestyle
• Wearing high heels for a long time
• excess weight
• Inherited collagenopathies leading to impaired collagen synthesis
• Overloading causes chronic damage to joint structures
• 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 intervertebral hernias, accompanied by nerve root compression

Ankle Arthritis: Symptoms

The main symptom of joint disease - pain prompts you to seek help from your doctor. At the beginning of the disease, the pain is bothersome only after prolonged exercise and decreases with rest.
Depending on the stage of pathological changes in the joint, the pain becomes more severe and persists at rest or even at night. Other symptoms occur.The disease is divided into three stages:

1. The first stage is characterized by mild swelling and redness of the skin around the joint, and pain in the afternoon or after strenuous exercise. The unpleasant sensation is concentrated on the front surface of the foot, the joint line and moves to the lateral surface of the ankle. X-rays of the feet may not show any changes yet.
2. In the second stage, the pain becomes constant, there is a crunching sound when moving the joint, movement is limited, and the joint becomes "stuck. "Growths along the edges of the joint surfaces of bones are evident on X-ray: tibia, ankle, and talus, as well as narrowing of the joint spaces
3. In the third stage, the joints deform, which is why only rocking, low-amplitude movements are possible. X-rays show massive bone hyperplasia and joint spaces that narrow or even disappear. Due to joint instability, patients often twist their legs, leading to sprains, torn ligaments, and worsening of general conditions, aggravating the condition.

Ankle pain is characterized by:

• The maximum value expressed at the beginning of exercise - the so-called onset pain
• As the load increases significantly, especially when running and jumping
• Often appears in the evening, middle of the night or just after waking up

Due to the pain, foot movement is limited and the joints become stuck due to the destruction of cartilage.
Symptoms appear in waves: exacerbations alternate with remissions. As the condition worsens, the symptoms become more obvious. During remission, symptoms gradually subside and may even disappear completely.

Which doctor should I contact?

If you experience pain and stiffness with ankle movement, you should consult an orthopedic traumatologist. If other causes of joint discomfort are discovered, a consultation with a neurologist, rheumatologist, or endocrinologist may be necessary.

diagnosis

To make a diagnosis, the doctor clarifies the complaint, specifying the period of time the pain was observed, which led to its onset and intensification. Specialists collect data on existing diseases, injuries and lifestyle characteristics, perform examinations, assess joint range of motion and perform diagnostic tests.Based on the information received, a diagnosis can be made, but in order to confirm the diagnosis and develop an effective treatment plan, additional testing methods are required, which may include:

• X-rays of the ankle joint are vital in diagnosing and determining the stage of the disease. Images show joint space narrowing, osteophytes at the edges of the articular surfaces of the bones, cysts, and signs of thinning of the bone beneath the cartilage
• CT scans of joints can provide a more detailed picture. Doctors can evaluate the condition of the patient's bone structure and cartilage tissue in detail
• MRI is used to study cartilage and soft tissue
• Joint Ultrasound to Evaluate the Structural Condition of Soft Joints

Treatment of Arthropathy

Pathological treatment is long-term and performed on an outpatient basis under the supervision of an orthopedic traumatologist. How you heal your leg joints depends on the stage of the injury and existing complications.The main goals of treating this disease in modern clinics are to relieve leg pain, improve the patient's quality of life and slow the progression of the joint disease. To do this, doctors develop a set of treatment and preventive measures, both pharmacological and non-pharmacological, and adjust the patient's lifestyle.

Correct lifestyle and nutrition

Adequate physical activity and nutritional correction will help inhibit degenerative changes. After the examination, the clinic's doctors can give weight loss recommendations and optimize leg load.

medical treatement

Medications are selected individually based on examination data, symptoms and concomitant diseases. Patients may be prescribed:

• Painkillers. Most commonly available as tablets, gels, or injections, NSAIDs are used to relieve pain and inflammation
• Antidepressants and anticonvulsants treat long-term, severe, difficult-to-treat pain

exercise therapy

Specially selected exercises can help maintain joint range of motion, reduce pain, and halt the progression of degenerative changes. The patient first performs recommended exercises under the supervision of a specialist, and then - alone, at home.

massage

Massage of the lower limbs normalizes the nutrition of joint tissues. It is prescribed outside of the acute phase. During treatment, experts will perform passive motions on the joints to prevent muscle shortening and joint stiffness.

Auxiliary equipment

Special orthotics, canes, and walkers may be recommended to relieve pressure and stabilize the ankle joint.

Surgery

It is only used in cases where articular cartilage is severely damaged and joint mobility is limited. A long period of recovery and conservative treatment is required after surgery. Endoprosthesis or arthroplasty in the later stages of ankle joint development – in fact, this is the only chance to avoid disability and maintain joint mobility.

Why are ankle joints dangerous?

The changes that have developed in the joints are irreversible. Therefore, the goal of treatment is to slow down the pathological process in order to preserve the patient's ability to work and quality of life. Achieving these goals is possible only with prompt treatment and strict compliance with the doctor's recommendations.
As arthrosis progresses, the joints will become significantly deformed. Range of motion is drastically reduced, so the ability to support the foot becomes difficult; walking without crutches or a cane is almost impossible.
Chronic ongoing pain in joints can lead to anxiety and depression.

prevention

Preventing joint disease includes the following measures:

• Avoid traumatic activities. For example, jumping from high places, running
• avoid injury
• Be careful when it's icy and wear non-slip shoes
• Weight control
• Normalizing your weight will help reduce pressure on your ankle joints
• stay moderately active
• An inactive lifestyle is dangerous and can lead to complications, excessive overload, and microtrauma
• Keep your joints healthy
• Seek medical attention promptly and treat musculoskeletal disorders

Main points of the article:

• The prevalence of degenerative dystrophic diseases of the foot joints is 87%
• Occupational hazards, daily habits, and past injuries can all contribute to ankle arthritis.
• Common symptoms of joint disease - pain, crunching when moving, localized swelling, and subsequent restriction of foot movement
• Treatment of the ankle joint is usually conservative and includes both pharmacological and non-pharmacological methods.
• Progression of the ankle leading to disability and complete loss of foot function