What is ankle osteoarthritis?

The ankle is often injured as a result of the high stress. A diagnosis like ankle osteoarthritis is not uncommon. It is placed regardless of the age and gender of the patient. What is ankle osteoarthritis and how can it be treated?

What is it?

The ankle is put under enormous strain. Its function is to keep the body upright. Thanks to him, a person walks and runs. When there is an injury to the ankle system, it is extremely difficult to lead a familiar way of life. What is interfering with the work of the ankle?

Ankle arthrosis, what is it? This is a chronic joint disease that is characterized by a degenerative course. In the articular cartilage, irreversible processes are triggered that lead to enormous complications.

Ankle arthrosis develops gradually. Healthy joint surfaces are elastic and smooth. They offer cushioning at high loads and smooth gliding while driving. In pathology, tissue trophism and metabolism are disturbed. The joint surface becomes inelastic and rough. When you move, the cartilages come into contact with each other, causing inflammation. When lifting weights, the main burden falls on the bones, which threaten degenerative diseases.

Lack of treatment leads to more serious disorders. Damage to the cartilage and tissue is observed in 3-4 stages. The synovial membrane becomes inflamed. The joint becomes unstable. The support function is violated. All of these violations add up to the fact that movement becomes impossible.

Osteoarthritis (osteoarthritis) is one of the most common joint diseases that affects many people.

Causes and Risk Factors

We have sorted out what osteoarthritis of the ankle is. Now let's find out what the cause is. Ankle arthrosis is considered to be an old age disease. This is due to age-related changes in the body. Cartilage becomes thinner, bones become unstable and fragile. However, over the past decade, the diagnosis of osteoarthritis of the ankle has become much younger. Such statistics are disappointing, as many patients ignore the first signs of the disease. Late diagnosis always threatens the development of serious complications.

The provoking factors include:

• Dislocations;
• Bruises;
• inflammatory diseases;
• Injury;
• Obesity;
• disturbed metabolism;
• unbearable physical activity;
• wearing uncomfortable shoes;
• Autoimmune and endocrine diseases;
• Osteochondrosis.

Clinical symptoms

Ankle arthrosis is recognized by the following features:

1. Pains. It is mild at first and occurs after walking or exercising. Sometimes when a person is in an uncomfortable position. As the pathological process progresses, the pain syndrome intensifies and worries even at rest.
2. Swelling and inflammation. These signs appear against the background of injuries and dislocations. The body temperature in the affected area rises.
3. Click. If the ankle is affected, the click is "dry" and causes an attack of pain.
4. Dislocation or subluxation. The thinning and breakdown of cartilage tissue makes the joint unstable. Bones can shift and fall out of the joint capsule. These changes cause bouts of acute pain.
5. Joint stiffness. When cartilage is replaced, the bone joint no longer functions normally, which has a negative effect on its mobility.
6. Joint deformity. The symptom occurs in 3-4 stages of osteoarthritis. Osteophytes also cause the ankle to curve.

If any of the symptoms occur, it is recommended that you seek medical attention immediately. Treatment started on time is a step towards recovery.

Osteoarthritis of the joints of the foot and ankle is characterized by slow progression with a gradual development of clinical manifestations over several years.

Classification and stages

The disease develops in different ways. In some patients, several years pass from the first signs to the terminal stage, in others the rapid development of the disease is observed. The speed depends on the age and state of health of the patient and the time at which the therapy is started. Symptoms of ankle osteoarthritis become lighter as the disease progresses.

There are four stages of osteoarthritis:

1. The first phase often goes unnoticed. Sometimes morning stiffness and ankle pain occur after vigorous exertion. A characteristic crunch can be heard when the foot moves. Pathological changes are not yet visible on X-rays, but the destructive process of the cartilage has already begun.
2. Morning stiffness is lengthened. It takes 20-30 minutes to develop a leg. Sometimes lameness occurs. X-rays show osteoarthritis of the 2nd degree of the ankle joint due to the growth of bone tissue, the displacement of the bones.
3. Symptoms in 3 stages are pronounced. Pain worries no longer only after heavy exertion, but also at rest. It is difficult for a patient to go without pain medication. Lameness increases. Crutches may be required. The affected joint is swollen and deformed. The ankle muscles atrophy. The x-ray shows a narrowing of the joint space, the formation of osteophytes, subluxation.
4. Level 4 is the most difficult. It develops as a result of a lack of treatment. The cartilage is destroyed, the surfaces of the joints are fused. Walking is no longer possible.

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

diagnosis

The diagnosis of ankle osteoarthritis is based on clinical symptoms and information obtained during the examinations. Laboratory studies are considered ineffective as there are no special tests that can detect a pathology. During the remission period, all indicators are in the normal range; if the disease worsens, a clinical blood test shows a high content of C-reactive protein and ESR. These indicators indicate that the pathological process has already begun.

To confirm the diagnosis, instrumental methods are used:

• X-ray;
• Magnetic resonance imaging;
• Ultrasonic;
• Bone scintigraphy;
• diagnostic joint puncture.

Simple x-ray

The simple X-ray is the most reliable and effective method for diagnosing diseases of the musculoskeletal system. The principle of manipulation is the different absorption of X-rays by the muscle tissue. Soft tissues let X-rays through, but hard tissues absorb them. An X-ray allows you to diagnose both the disease itself and its consequences.

Conventional radiography is a type of examination in which a small amount of X-rays are transmitted through a person's body or part of a body.

The snapshot allows you to see:

1. The condition of the bone surfaces in the joint.
2. The shape, size and arrangement of the structures in the joint are relative to one another.
3. The condition of the fabric.
4. The size of the joint space.

These indicators will help the doctor determine the type and extent of joint damage. If the data are insufficient, doctors will prescribe other studies.

In the case of osteoarthritis of the ankle, an X-ray is taken in three projections:

• Page;
• return;
• back with one foot moved inward.

The disease is characterized by the following changes:

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

Nuclear magnetic resonance

Using nuclear magnetic resonance (NMR) as a diagnostic method, you can examine the parts of the body that have water in them. The picture shows bones darker in color because they contain less water, but muscle tissue, intervertebral discs and nerves are shown lighter. With the MRI you can see the smallest changes in the structure of bone tissue and joints. The study is also prescribed to patients before a joint prosthesis. YMG has one disadvantage - a high price.

In nuclear magnetic resonance, a change in the properties of hydrogen molecules under the influence of a strong magnetic field is recorded.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is an alternative diagnostic method that allows you to carefully examine the ligament structure of the joint, muscle, and cartilage tissue. With the help of an MRI, the doctor assesses the condition of the lower leg joints. Based on the survey data, the pathology is revealed at an early stage of development.

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

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

When diagnosing osteoarthritis of the ankle, classic (closed) MRI machines are used because they have better image quality. An MRI machine is a large, cylindrical tube with a magnet around it. The patient lies down on a special table. The ankle is fixed with a special spiral. The procedure takes 30-40 minutes. The course is absolutely painless. Patients can feel warmth in the lower leg area.

Ultrasonic

Ultrasound examinations have been widely used in medicine since the 1990s. This technique has proven itself well in making accurate diagnoses. If you have osteoarthritis of the ankle, an ultrasound scan is also done.

Today, the ultrasound examination is of no particular importance in the diagnosis of osteoarthritis, as it does not allow a sufficiently good examination of the damaged joints.

The device used to conduct the study generates waves at ultra frequencies. The waves are reflected by the tissue and recorded on the monitor. Based on the resulting picture, the doctor determines the nature of the pathology. To make the picture on the monitor clear, a special gel is used. It eliminates air gaps and allows the sensor to slide better.

The ultrasound scan does not harm the patient, so the process can be repeated many times. The advantages of ultrasound also include its low cost and high accuracy.

The following indicators are clear signs of osteoarthritis:

• Thinning of cartilage;
• the presence of bone growth;
• Accumulation of effusion in the joint cavity (synovitis);
• Loss of cartilage space.

Bone scintigraphy

Scintigraphy is a highly precise study that can use isotopes to detect pathological changes in the bones. Doctors divide the disease centers into "cold" and "hot". In the first case, we are talking about zones where there are no isotopes. These areas are poorly supplied with blood and are not visible when scanning. "Cold" areas are places that are affected by malignant tumors. Isotopes accumulate quickly in "hot" areas and they look very bright when scanned. Such areas indicate the presence of inflammatory processes.

The role of scintigraphy in osteoarthritis is important. The study helps differentiate osteoarthritis from a number of other conditions when the clinical symptoms are very similar.

In bone scintigraphy, a special preparation with specially marked atoms is injected into the body.

Based on the results of the scintigraphy, the doctor prepares a clinical prognosis and determines the treatment regimen. The only downside to the study is its high cost. Scintigraphy is performed with special equipment, which unfortunately not all medical institutions can afford.

While radioactive scanning is a safe practice, there are still a number of contraindications:

• Pregnancy;
• Breastfeeding;
• Taking medication containing barium.

When injecting a radioactive substance, some people experience an allergic reaction in the form of itching and a rash. These side effects are not dangerous and will go away on their own in a short time.

Joint puncture

Joint puncture is a diagnostic procedure that involves inserting a needle into the joint cavity to collect synovial fluid. This liquid is then sent for further research. Based on the data obtained, the doctor draws a conclusion about the nature of the disease and the stage of its development.

At first glance, a puncture is an easy procedure, but it isn't. Withdrawal of fluid from the joint capsule requires exceptional accuracy in the physician's movements. The synovium is very thin and awkward movement traumatizes it. As a result, an inflammatory process develops. Infections are also some of the possible risks. Getting the infection into the joint capsule through poorly sterilized instruments is not difficult.

The manipulation technique is different for each joint. When the joint exudate is removed from the ankle, the puncture is made in front between the outer ankle and the tendon of the extensor digitorum longus muscle.

Diagnostic sampling of intra-articular fluid enables laboratory analysis and rules out inflammatory arthritis.

Basic principles of treatment

Once the diagnosis of osteoarthritis of the ankle is confirmed, the symptoms are not long in coming. Treatment is started immediately. The further prognosis depends on a well-chosen treatment regimen and the timeliness of the start.

Osteoarthritis is an insidious disease. It cannot be completely cured. The aim of therapy is to stop degenerative processes and extend the duration of remission. To do this, doctors prescribe drugs, physiotherapy, massage, remedial gymnastics and folk remedies. If all the conditions are met, a positive dynamic can be expected, otherwise the disease will progress.

Drug therapy for osteoarthritis

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

1. Anti-inflammatory or pain relievers. This group of drugs is aimed at eliminating the focus of inflammation and relieving pain. The earlier anti-inflammatory therapy is started, the greater the chances of saving the joint. Medicines of this group can be made in the form of tablets and ointments.
2. Glucocorticoids. These drugs are prescribed when the above means are ineffective. They are made in the form of a solution for injection. The drug is injected directly into the joint.
3. Chondroprotectors. Designed to slow down the destruction of cartilage.

The treatment regimen and dosage will be selected by the doctor based on the severity of symptoms, the patient's age, the presence of any comorbid conditions, and other factors. Self-medication is dangerous and often makes the situation worse, as many of the drugs have a number of side effects and have their own contraindications.

Features of radical treatment

When conservative therapy has failed, doctors are forced to resort to a radical method of treatment (surgery). The process is also indicated if:

• secondary (post-traumatic) and primary osteoarthritis of 3-4 degrees;
• Osteoarthritis with complications;
• constant and severe pain in the ankle radiating to the knee;
• severe lameness;
• paresis and paralysis of the leg muscles;
• violation of the flexion and extension function of the joint;
• Violation of the supporting ability of the foot.

Surgical intervention is contraindicated if:

• the patient is under 12 years old;
• Fistulas are found in the joint;
• the patient has a history of diabetes mellitus, heart failure;
• Infectious diseases were found in the area of the planned intervention.

Traditional treatment

Doctors believe that the treatment of osteoarthritis should be carried out exclusively under the supervision of a specialist, but do not deny the beneficial effects of folk remedies. Alternative medicine acts as an effective prophylaxis that helps eliminate symptoms and maintain remission.

Folk remedies are rather symptomatic treatment of osteoarthritis of the foot.

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

Traditional healers recommend treating ankle osteoarthritis with:

1. Burdock. Wash the burdock leaves with soap and running water. Apply the leaves to your skin with the soft side. Secure the top with a bandage or cling film. It is better to keep the compress all night.
2. Sea-salt. Chop the salt in a pan. Pour it into a linen pouch and attach it to your ankle. Hold the bag until the salt cools. Warmth relieves pain. Instead of salt, sand, lentils, buckwheat are also used.
3. Lilac. Pour the triple cologne over the purple flowers. Let the tincture stand in a dark and cool place for 10-14 days. Rub the affected area in the morning and evening.
4. Eggshell. Grind the shells in a coffee grinder. Take the resulting powder for ½ tsp. before the meal.

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

surgery

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

• arthrodesis of the joint;
• Arthroscopy of the joint;
• Endoprosthetics.

Arthrodesis is an operation to immobilize a joint. It is performed to restore the limb of the lost supportive ability. The only disadvantage of the operation is that the bones (tibia and talus) grow together, resulting in 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 an arthroscope through them (a special tube with a camera installed at the end). With its help, the surgeon carefully examines and assesses the condition of the intra-articular structures. If necessary, parts of the damaged joint or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only disadvantage of arthroscopy is that the risk of recurrence is too high.

Endoprosthetics are a last resort. It is used for advanced osteoarthritis. With endoprosthetics, you can partially or completely replace the affected joint. Innovative prostheses with modernized mechanics are used as prosthetic products. An artificial joint lasts 10 to 20 years.

Performance characteristics

In order to achieve a favorable result, drug treatment is supplemented with diet therapy. Nutritionists have developed a special diet to prevent the disease from getting worse, while providing the body with all the necessary vitamins and nutrients. The diet for overweight patients plays a special role. Since obesity is one of the reasons for developing osteoarthritis, weight correction is an integral part of treatment.

The patient needs to rethink some of his everyday habits that contribute to and provoke the progression of osteoarthritis of the foot.

Nutritionists recommend adhering to the following nutritional conditions:

1. Eat often and in small portions.
2. Drink at least 2 liters of fluids a day.
3. Avoid sweets and salt.
4. The last meal is no later than 6: 00 p. m.
5. Dishes can be steamed, boiled or baked.

The main task of the diet in osteoarthritis is a balanced and enriched diet. Fasting is out of the question. Hard diets and body cleansing do more harm than good. Calcium is flushed out of the body, which is necessary for the restoration of the cartilage. A nutritionist will help you put together a daily diet.

With osteoarthritis, grains, pasta, dairy products, cheese, legumes, vegetables, fruit, rye bread, dried fruits, nuts, fish, poultry meat can be eaten. Heavy and fatty side dishes, colored and flavoring foods as well as pickles, marinades, smoked meat, fatty broths, baked goods, spices, sauces, chocolate, ice cream, coffee and alcohol are prohibited.

Osteoarthritis prevention

To avoid developing osteoarthritis of the ankle, doctors recommend taking preventive measures:

• wear comfortable shoes without heels;
• stick to a diet and drink enough fluids;
• take vitamin and mineral complexes seasonally;
• Bathe;
• Walk more in the fresh air;
• eliminate excessive load on the legs;
• Avoid hypothermia;
• be examined by a doctor in a timely manner.

If you have osteoarthritis, it is recommended to correct your lifestyle:

1. To reject bad habits. It has been shown to cause blood congestion in the tissue and accelerate the destruction of cartilage.
2. Do a series of exercises to warm up the ankle.

forecast

Osteoarthritis is a progressive disease. Without treatment, it leads to irreversible consequences and complete immobility of the joint. Early diagnosis of the pathology allows you to abandon radical measures. Drugs can suspend the pathological process and alleviate the patient's condition. The fight against the disease in its early stages proceeds without complications.