Osteoarthritis arthrosis: symptoms and treatment

Arthrosis of the ankle: symptoms, treatment and prevention

Deforming arthrosis most often affects joints of the lower extremities, one of which is ankle.

These joints have great mobility in different planes and perform an important function in walking (a roll of the foot and the transfer of body weight from the calcaneal region to the toe), and also carry the body weight rights.

Osteoarthritis of the ankle is a kind of payment for uprightness. But many other factors have a certain significance in the development of the disease.

With advanced arthrosis, a person is not able to move without support and experiences severe pain, especially when resting on the leg. Invalidization is possible in a few years after the onset of the disease, unless early and complex treatment is started.

Causes of the disease

Previously injured ankle joints increase the likelihood of developing a degenerative process in it.

• Increased body weight;
• Flat feet, congenital deformities of feet (horse foot, club foot);
• Disturbance of metabolism in diseases such as diabetes mellitus, gout, atherosclerosis of the vessels of the legs;
• Postponed joint injuries, for example, ligament damage, fractures of the ankles and bones of the foot;
• Permanent overload of the joint, resulting in microtraumatism (in athletes and people carrying gravity);
• Hereditary predisposition to joint arthrosis;
• Previous inflammation of the joint (arthritis) is infectious or in systemic diseases (rheumatoid, psoriatic, gouty arthritis).

Depending on the absence or presence of a specific factor that caused the disease, arthrosis of the ankle may be primary or secondary. There is also a division into stages. In the presence of the 1st stage a person is able to work, if the arthrosis has passed into the 2nd and 3rd stage, pain and limitation of mobility lead to disability (temporary or complete).

Symptoms of arthrosis of the ankle

• "Start" pain. This is one of the earliest symptoms of ankle arthrosis. The pain appears after a long sitting while trying to lean on the leg, can be accompanied by a short-term stiffness of movements in the joint. After several steps, the pain passes;
• Pain during exercise and after it;
• Night aching pain, it is associated with the inflammatory process, which is triggered by the destruction of cartilaginous tissue;
• Crunch, clicks in the joint when moving;
• Swelling, especially noticeable under the ankles;
• Restriction of movements;
• Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that the person begins to spare the aching leg;
• Deformation of the joint at the last stage of arthrosis.

Diagnostics

It is necessary to distinguish arthrosis and its aggravation from various inflammatory processes in the joint, for example, as a result of rheumatoid arthritic or psoriatic arthritis.

Therefore, the doctor appoints a detailed blood test, rheumatoid tests, a test for CRP, uric acid. With arthrosis, these rates are normal, but if the disease is in the acute stage, ESR and leukocytes can be increased.

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To determine the stage of arthrosis and obtain more detailed information about the pathology, radiography is used in 2 projections, ultrasound, CT or MRI of the joint. On the x-ray image, a slight narrowing of the joint gap can be noted, if the arthrosis is at the 1 st stage.

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At the transition to the 2 nd stage, the joint gap is reduced by 40% or more from the norm. And at the third stage it is considerably narrowed, it can be practically absent, and bone growth and deformation are visible.

Methods of treatment

Osteoarthritis of the ankle, as well as other localizations, involves complex, long-term and course treatment.

1. Unloading of the ankle joint in the period of severe exacerbation (walking with a cane from the side of a healthy limb), using a bandage;
2. Elimination of shock loads (jumping, running), vibration, weight transfer, prolonged stay on legs;
3. Control of body weight;
4. To give up smoking;
5. Wearing a semi-rigid orthosis with concomitant instability of the joint;
6. Physiotherapy (UHF, CMT, laser therapy, magnetotherapy);
7. Medication:

• NSAIDs are external, inward, in injections;
• glucocorticoids (kenalog, diprospan), along with anesthetics (lidocaine, novocaine) intraarticularly and periarticularly for relief of inflammation;
• vascular agents;
• muscle relaxants for the purpose of eliminating spasm of muscle tissue;
• Chondroprotectors - drugs that are injected intra-articularly (Ajflutop) are more effective. If there is no possibility to receive intraarticular injections, intramuscular injection is indicated (Alflutop, Chondrogard), ingestion (Arthra, Structum);
• preparations of hyaluronic acid (Synvisc, Gilgan, Fermatron) to restore the quality of synovial fluid.

1. Orthopedic insoles, wearing comfortable shoes on a small heel;
2. Gymnastics for strengthening the musculoskeletal apparatus. The proposed exercises should be performed daily:

• lying down or sitting bend and unbend the toes 10 times;
• lying down or sitting pulling feet on yourself and yourself 10 times;
• turn the feet outward and inward 10 times;
• to make circular movements in stops and counterclockwise 10 times;
• sitting on a chair, put feet on the floor with socks and heels together, alternately rearrange the legs back and forth, repeat 15-20 times.

1. Swimming, aqua aerobics;
2. At the third stage of arthrosis and ineffectiveness of conservative treatment, an ankle arthroplasty or removal the destroyed cartilaginous cover and the capsule of the joint with the closure of it with the help of a rod structure, or Ilizarov's apparatus (arthrodesis).

Prevention

To reduce the risk of developing arthrosis, the diet should give preference to foods high in protein, and sharp, salty, fried foods and alcohol to be excluded from the diet.

• Avoid injury to the joint. To do this, try not to wear shoes on an unstable heel, too firm sole, when using sports to use special protective equipment;
• Monitor body weight;
• It is necessary to adhere to a diet, i.e., eat more foods rich in protein, and refrain from salty, spicy, fried, alcohol;
• In time to treat and correct metabolic disorders, endocrine, vascular diseases;
• Perform the above exercises for ankle joints.

The effectiveness of treatment of deforming arthrosis of the ankle depends on the stage of its development and the presence of concomitant diseases. In any case, if conservative therapy is indicated, it should include medicines, physical methods, as well as correction with orthopedic products.

To which doctor to apply

With pain in the ankle, you need to contact a rheumatologist. The doctor will prescribe gymnastics, medications, will identify the cause of the disease. With diabetes or gout it will be useful to visit an endocrinologist, with atherosclerosis of the vessels of the lower extremities - the vascular surgeon and cardiologist.

An important role in the treatment is played by the orthopedist - he not only helps to pick the right shoes, orthopedic insoles, but also performs an operation if necessary. If you are overweight, you need to see a nutritionist and choose the right food. Non-drug treatment is conducted with the participation of a physiotherapist.

Crunch in the joints: causes and treatment

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Ankle Arthrosis Overview: Causes, Symptoms and Treatment

articles:

Arthrosis of the ankle joint is a gradually developing, chronic defeat of articular cartilage, in which cartilage is thinned and destroyed. In the late stages, the ailment leads to a complete disruption of the ankle.

Click on photo to enlarge

At the beginning of the development of the disease, the symptoms are minor, unstable, practically do not disturb the patient. And not later stages, even disability can occur, when a person can not walk.

With pathology, a gradual destruction of the cartilaginous surface of the joint occurs: the disease begins with a decrease in the production synovial fluid, which nourishes and lubricates the cartilage, and ends with its attrition and overgrowth of the joint cavity.The arthrosis of the ankle, unfortunately, is unfortunately irreversible, but to slow its development so that it never forces you to sit in a wheelchair, and you led a full-fledged way of life - it is quite possible.

Read further the review of the disease: the causes, the characteristic symptoms of the disease. Which doctor to go to, and what can he appoint?

Seven causes of arthrosis of the ankle

Seven main causes of the disease:

1. Age changes in the joints and ligaments. 80% of patients who are diagnosed with this disease are people over 60 years old. Those who are initially healthy and have no other prerequisites for the development of ankle arthrosis, the disease progresses more slowly and rarely ends up with a disability.

2. Obesity of 2-4 degree. Excess body weight increases the load on the joints of the legs and leads to an earlier wear. If a person is obese from childhood, arthrosis can develop in him already by 20-25 years.

3. An increased burden on the ankle joints: professional sports (running, soccer, figure skating), work associated with standing on the legs, carrying weights and long walking.

4. Fractures of bones in an ankle.

5. Flattening and other types of congenital and acquired deformities of the foot.

6. Heredity. In people whose blood relatives suffer from osteoarthritis of any joints, the risk of getting sick is higher than those of those whose family is healthy.

7. Long-term wearing of shoes with too high a heel or flat sole. Almost 100% of the sick for this reason - women over 35 years. For permanent wearing orthopedists are advised to select shoes, the height of the heel which is equal to the length of the foot (in centimeters), divided by 7.

From the first symptoms to the final stage of the disease (complete immobility of the joint) many years pass.

In time, the treatment started can "freeze" arthrosis of the ankle in one of the early stages, while the cartilage is not yet destroyed and can perform its functions.

Step 1

The first stage of arthrosis does not worry the patient too much.

The only symptoms are short-term morning stiffness in the legs (not longer than 15 minutes), as well as pain in the ankles and fatigue of the legs when passing a distance of more than a kilometer. Flexion and extension of the foot can be accompanied by a crunch.

The joint X-ray at the first stage of arthrosis does not show pathological changes, but the process of cartilage destruction is already underway.The treatment started in this period gives the best results.

Step 2

In the second stage, the initial symptoms increase. Morning stiffness lasts from 30 minutes and is accompanied by lameness.

There are starting pains in the beginning of walking. The distance a person can overcome without pain and fatigue in his legs is less than 1 km.

When you move in the ankle, a distinct crunch is heard.

On the x-ray, osteophytes are defined - the growth of bone tissue along the edges of the joint gap, as well as the convergence of the ends of the bones that form the joint (epiphyses). Treatment without surgery is still possible, but it will be more time-consuming and costly.

Step 3

At this stage arthrosis of the ankle is manifested as brightly as possible. Pain occurs not only when walking, but also with any movement in the ankle, and also at rest.

Patients are forced to constantly take pain medication, without which they can not fall asleep. Self-movement is severely limited or possible only with the help of crutches. The joints are noticeably deformed and enlarged in volume.

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Ankle arthrosis is associated with inflammation, the muscles of the shin gradually atrophy.

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On the roentgenogram, a strong narrowing of the joint gap and a flattening of the surfaces of the bones forming it, pronounced outgrowths of osteophytes, sometimes - subluxation (displacement of the epiphyses of bones relative to their correct provisions). The treatment is purely surgical. Conservative therapy in this period is only aimed at alleviating the suffering of the patient - reducing pain and relieving inflammation.

Step 4

At the fourth, the last stage of arthrosis of the ankle, which inevitably develops in the absence of adequate treatment at the onset of the disease, the symptoms subside.

The pains pass, however, the volume of movements in the ankles decreases so much that walking becomes impossible.

The radiograph shows the partial or complete overgrowth of the joint space. Treatment is the same as in the third stage.

Traditional and folk treatment

All therapies for this disease are directed to:

• Suspension of degenerative-dystrophic process in articular cartilage;
• restoration of joint function;
• elimination of symptoms that cause discomfort to the patient;
• rehabilitation of disabled people and patients after surgical treatment.

If you suspect arthrosis of the ankle joint, do not delay the visit to the doctor. Address to the therapist or to the narrow expert - to the rheumatologist.

Ignore the initial symptoms, and even more so self-medication before the diagnosis is to go on the road that leads to disability.Remember that severe forms of arthrosis never occur suddenly.

They are always preceded by the stages when the pathological process can be stopped.

What will the doctor appoint?

Treatment of ankle arthrosis is a complex of measures that affect all links of the pathological process.

• To relieve pain and inflammation, patients undergo short courses of therapy with nonsteroidal anti-inflammatory drugs - indomethacin, ibuprofen, diclofenac, piroxicam, flurbiprofen. Preparations are prescribed in injections, tablets and ointments (gels). The choice of the optimal dosage form, dosage and duration of the course is performed by the doctor.
• To normalize the production of synovial fluid and improve the state of cartilaginous tissue, chondroprotectors are prescribed: arthra, don, structum, elbon, chondrolon. To achieve a lasting improvement, the course of therapy is repeated 2-3 times a year. The optimal duration of one course is 90-150 days when taking the drug inside and 12-25 days after receiving it in injections. A good effect is the introduction of chondroprotectors into the joint cavity.
• To quickly remove the symptoms of inflammation and relieve pain, intraarticular injections of corticosteroid hormones (drugs dipisane, hydrocorizonum, celeston, kenalog) - an average of 3-5 injections in each joint every 1-2 times of the week.
• To restore mobility of the ankles, giving the pseudomonas the bones of the correct position and eliminating friction of articular surfaces against each other is effective manual therapy and traction of joints on devices of the type Ormed.
• Improve the blood circulation in the affected limb and accelerate the recovery process helps physiotherapy: laser irradiation, magnet, electrostimulation, ultrasound.
• For the longest possible preservation of the functions of ankle joints, therapeutic physical training is very important. It must be dealt with constantly, excluding periods of exacerbations.
• With the transition of arthrosis in stages 3 and 4, surgical treatment is shown - endoprosthetics of the ankle - replacement of affected tissues with a metal prosthesis.

Physiotherapy

Carry out this set of exercises daily, and after 1-2 weeks you will feel relief.

(if the table is not completely visible - turn it to the right)

Diet in excess weight

The higher the mass of the body, the heavier the arthrosis of the ankle joint and the worse it gives in to treatment. Dietotherapy for leg arthrosis is aimed at normalizing weight and metabolism.

Exclude from the diet high-calorie foods, especially fatty meat, sausages and fast food. Instead, try to eat green vegetables, dishes from cereals, especially with bran (oats, brown rice), chicken and quail eggs, poultry, sea fish, sour-milk products, baked potatoes.

Traditional medicine

From what the traditional medicine offers for arthrosis of the ankle joint, the best effect is given by compresses made from canned bile and bischofite by courses from a week to a month.

How to make a compress: soak the cheesecloth wrapped in 4 layers with curative fluid, attach it to the joint, wrap it on top with a layer of food film and fix it with a bandage. Remove the bandage after 7-8 hours, rinse the foot with water and apply cream. Repeat until you feel relieved.

Svetlana Kant

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Osteoarthritis arthrosis: symptoms and treatment

Category: Joints, bones, muscles 7660

• Sleep disturbance
• Pain in the ankle
• Deformation of the joint
• Increased temperature in the affected area
• Increased fatigue of the legs
• Stiffness in the joints in the mornings
• Puffiness in the affected area
• Crunch in the affected joint
• Sensitivity of joint to weather change
• Redness of the skin above the affected joint
• Limited mobility of the ankle
• Discomfort in the joint after walking on his heels

Arthrosis of the ankle joint is a dystrophic degenerative pathological disorder characterized by gradual destruction cartilage, joint and adjacent bone structures, as well as ligaments and even muscles, which leads to impaired mobility and even disability patient. The cause of the development of such a pathology may be traumatic damage, posttraumatic arthrosis of the ankle, metabolic disorders in the body or some inflammatory diseases.

Diagnosis of pathology is established taking into account the patient's complaints, as well as on the basis of the results of radiographic examination and ultrasound. Treat the disease should be predominantly conservative and only in severe (neglected) cases is shown surgical intervention.

The disease has a chronic undulating course, in which the periods of exacerbation alternate with periods of calm, but still progressing pathology even in the absence of symptoms continues, so over time, the ankle completely destroyed, if not treated. Suffer from arthrosis most often older people, in view of the natural processes of metabolic disorders in the body, but there are other reasons for the development of arthrosis.

Causes

In medical practice, two types of arthrosis are distinguished: primary and secondary. The primary develops as an independent pathology, with no apparent cause. Secondary is the result of any adverse effects, for example, traumatic injuries.

The main causes of the onset of the disease can be:

• diabetes;
• thyroid disease;
• excess weight;
• permanent microtrauma, which can occur in people involved in sports, or regularly walking on high heels;
• rheumatic pathologies;
• traumatic injuries in this area (fracture, dislocation);
• inflammatory processes that develop due to diseases such as gout, arthritis;
• hereditary disorders of metabolic processes, leading to tissue thinning.

Osteoarthritis of the ankle

Sometimes the disease occurs in children, and its causes can be:

• dysplasia of tissues;
• congenital anomalies;
• thyrotoxicosis;
• injuries;
• articular inflammatory ailments.

Degrees and symptoms

Osteoarthritis of the ankle has three degrees of flow, which determine the symptoms of the disease.

It is important to remember that the disease develops gradually, therefore, and violations in the joint will be initially minor, and then more pronounced.

At the same time, the changes that have appeared are already incorrigible, and the treatment of pathology at one stage or another will consist only in preventing the progression of the disease.

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At the first degree of the disease the tissue is thinned, and this does not happen on the whole surface, but in specific parts - specific islets are formed.

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The disease of the first degree is characterized by the following symptoms:

• excessive fatigue with prolonged load on the legs;
• discomfort in the joint area after walking on his heels;
• minor pain, disappearing at rest.

When X-ray or ultrasound examination, no pathological changes in the joint are detected, therefore at this stage it is impossible to diagnose doctors.

At the first stage of the disease, it can be treated at home with folk remedies - first of all, to refuse to wear shoes on heels, to lose weight (if necessary), to engage in exercise therapy, as well as to use some folk methods, which will be told below.

At the second degree of the pathological process in those areas where the tissue is thinned, the load falls on the underlying bone.

Symptoms of the second degree of arthrosis are more obvious:

• pain with a lesser load, which does not go right after it stops;
• the occurrence of nocturnal pains that disturb the quality of sleep;
• limitation of mobility of the joint in the morning (takes some time to make it work);
• joint response to weather.

At the third degree develops deforming arthrosis of the ankle joint.

During this period, the tissues of the entire joint become thinner, like bone structures, the muscles on one side overstretch, and on the other, on the contrary, spasmodic, trying to keep the joint in the correct position.

Symptoms of the third degree of such pathology as deforming arthrosis of the ankle joint are associated with a complete violation of its mobility and strong pain sensations:

• severe pain, which does not stop even at rest;
• in the morning hours the joint requires a long development, even in order to make minimal movements;
• sensation of crunch;
• the need for taking pain medication to stop pain;
• restriction or even complete impairment of mobility in the affected area.

Such pathology as traumatic arthrosis of the ankle joint is characterized by some other symptoms:

• swelling and redness in the affected area;
• local temperature increase;
• crunch or crepitus.

Symptoms of arthrosis of the ankle

Diagnosis and treatment

A decisive role in the diagnosis of the disease is given to radiographic examination.

However, it is important for the doctor to listen to the patient's complaints, which may allow him to make a diagnosis at an early stage, when the radiographic changes are not visible.

In severe cases, the patient is referred to CT ankle or MRI.

Treatment of arthrosis of the ankle depends on the stage of the disease. At the initial stage, it is enough to change the way of life and the correct motor mode. It will be superfluous at this stage massage and exercise therapy, which will improve blood supply.

If we talk about treatment with folk remedies that can be used at home, it can reduce pain and remove the inflammatory process.

Such folk remedies that any person can use at home are:

• rubbing olive oil in the affected area in the morning;
• use of burdock leaves in the form of attachments on the joint for the whole night;
• Preparation of the ointment from the comfrey and rubbing it into the affected area twice a day;
• Reception mummy inside in the form of tablets and rubbing it into the affected joint.

There are other folk methods of treatment, but it is important to remember that they are not a panacea for the disease and that only their integrated Use together with drug therapy, diet, exercise therapy and the right way of life will stop the progression destruction.

If we talk about the treatment of ankle arthrosis medically, it consists of the use of anti-inflammatory and analgesic drugs, such as Diclofenac, Nimesil and others. In addition, patients are assigned chondroprotectors that protect the joint for a long time (at least six months).

To improve the nutrition of the affected joint, the reception of vascular drugs such as nicotinic acid or Trental is indicated. It is considered effective therapy with hyaluronic acid, and in some cases requires a single dose of hormones.

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It is also necessary to treat the disease in a complex by physiotherapy methods. Showing special exercises for arthrosis of the ankle joint, which in each case is selected by a physician-physiotherapist.

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It is very important that gymnastics for arthrosis of the ankle does not cause pain to the patient, but at the same time a person should experience some discomfort, because otherwise the procedure will be ineffective.

Among other physiotherapeutic methods, the following are shown:

• magnetotherapy;
• laser therapy;
• phonophoresis;
• thermal procedures and some other kinds of impact.

Surgical surgery for this disease is only indicated in severe cases, when the joint is completely destroyed. Often patients get a joint prosthesis that returns mobility to their limbs, but other surgical techniques are also used - the choice is made by the doctor taking into account the patient's condition.

Diseases with similar symptoms:

Osteoarthrosis of the ankle joint (coinciding symptoms: 7 of 12)

Osteoarthritis of the ankle is a pathological condition characterized by joint articulation and subsequent disruption of its functioning.

Mostly elderly people suffer from the disease, but those who suffer from excess weight, can get sick of this pathology and at a young age.

This disease affects not only the joint, but also the surrounding tissue - ligaments, cartilage, bones, so the disease is a serious inconvenience to man, because he does not only experiencing pain, but also he still has gait disturbances due to ankle deformity - in this case they say about deforming osteoarthritis of the ankle the joint.

... Osteoarthritis of the knee joint (coinciding symptoms: 4 of 12)

One of the frequent complaints that a doctor hears from patients is the pain in the knees.

It is also known as gonarthrosis, and is a joint injury that usually non-inflammatory character and promotes destruction of cartilage, deformation of bones and restriction of movements patient.

... Arthrosis of the shoulder joint (coinciding symptoms: 4 of 12)

Well-known for many people, mostly elderly, are joint pain. They are caused by malnutrition, hypodynamia, stress, high physical stress and other factors.

Quite often in the elderly and a small percentage of young people there is arthrosis of the shoulder joint - a chronic ailment that causes serious deformations of cartilage, as well as tissues adjacent to it, and bones.

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It has a progressive type, and the symptoms may not appear for years, and then sharpen sharply.

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The most common signs are pain in the shoulders after a long stay at low temperatures, as well as after lifting objects that have a large mass.

... Deforming osteoarthritis (coinciding symptoms: 4 of 12)

Deforming osteoarthritis - is considered a frequent pathology of joints, against which there is development degenerative-inflammatory process, leading to the destruction of their structures and their premature aging.

The main reason for the development of this pathology is excessive physical activity, but there are a number of other predisposing factors.

They include excess body weight, professional sports, sedentary working conditions and many other sources.

... Osteoarthritis (coinciding symptoms: 3 of 12)

And they have significant differences. It is important to study their main symptoms, so that when they manifest, immediately visit a medical institution. It is also necessary to know which doctor treats arthrosis in time to apply to a qualified honey. specialist.

...

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Osteoarthritis of the ankle

Osteoarthritis of the ankle- a chronic disease of a degenerative-dystrophic nature. First of all, cartilage is affected, with time the pathological process covers all joint tissues: capsule, synovial membrane, bones, ligaments and adjacent muscles.

The cause of development can be trauma, developmental disorders, excessive loads, some inflammatory diseases and metabolic disorders. In some cases, the disease occurs for no apparent reason. It is manifested by restriction of movements and pains in the joint.

The diagnosis of arthrosis is made on the basis of symptoms, examination data and radiography. Treatment is usually conservative, anti-inflammatory drugs of general and local action, means for restoring cartilage and glucocorticoids are used, prescribed by exercise therapy and physiotherapy.

In severe cases, operations are performed.

Osteoarthritis of the ankle is a disease in which the articular cartilage and surrounding tissues are gradually destroyed.

The disease is based on degenerative-dystrophic processes, inflammation in the joint is secondary.

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Osteoarthritis has a chronic undulating course with alternating remissions and exacerbations, and gradually progresses. Women and men suffer equally often.

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The likelihood of development increases dramatically with age. At the same time, experts note that the disease "gets younger" - every third case of arthrosis of the ankle joint is currently being detected in persons younger than 45 years.

Causes of development

There are two groups of arthrosis: primary and secondary. Primary arthrosis occurs without any apparent cause.

The secondary develops under the influence of some unfavorable factors: trauma, inflammation, etc.

The main causes and predisposing factors of the development of secondary arthrosis of the ankle joint:

• Major injuries of the joint (fractures of the ankles and talus, tears and ligament ruptures).
• Constant microtrauma.
• Excess weight.
• Operations on the ankle joint.
• Excessive workload: too intense exercise, long walking or standing in standing position, conditioned by working conditions, etc.
• Wearing shoes with heels.
• Diseases and conditions associated with metabolic disorders (diabetes mellitus, gout, pseudogout, estrogen deficiency in postmenopause, etc.).
• Rheumatic diseases (SLE, rheumatoid arthritis).
• Osteochondrosis of the lumbar spine, intervertebral hernia and other conditions, which are accompanied by nerve impairment and disruption of the muscular apparatus of the foot and lower leg.

Less common cause of arthrosis are nonspecific purulent arthritis, arthritis in specific infections (tuberculosis, syphilis) and congenital malformations. A certain role in the development of arthrosis is played by an unfavorable ecological situation and hereditary predisposition.

Normally, the articular surfaces are smooth, elastic. They freely slide relative to each other during movements and provide effective cushioning under load.

As a result of mechanical damage (injury) or metabolic disorders, cartilage loses its smoothness, becomes rough and inelastic.

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Cartilage "rubs" during movements and more and more injures each other, which leads to aggravation of pathological changes.

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Due to insufficient depreciation, excessive load is transferred to the underlying bone, and in it too degenerative-dystrophic disorders develop: the bone deforms and grows at the edges of the joint site.

Because of secondary trauma and disruption of normal joint biomechanics, not only cartilage and bone, but also surrounding tissues, suffer. The joint capsule and the synovial membrane thicken, foci of fibrous degeneration are formed in the ligaments and periarticular muscles.

In severe cases, the articular surfaces are destroyed, the supporting function of the limb is disrupted, and movements become impossible.

Symptoms of arthrosis of the ankle

First, there is rapid fatigue and unsharp pain after a significant load. In the following, the pain syndrome becomes more intense. The pains appear not only after the load, but also at night.

Gradually, visible deformation is formed, the volume of movements in the joint decreases, with movements, a crunch is heard.

In the later stages of the movement, the movement is severely restricted, the support is difficult, while moving, patients are forced to use crutches or a cane.

Distinctive features of pain syndrome and other symptoms with arthrosis:

• Characteristic initial pains that arise after a state of rest, and then gradually disappear when moving.
• There is an increase in pain during exercise and fatigue of the joint.
• When moving, there may be a crunch, a creak or clicks.
• Night pains usually appear in the morning.
• During the exacerbation, the joint area may be swollen and reddened.
• Because of the instability of the joint, the patient often podvorachivaet leg, there are stretching and tearing ligament.
• Stiffness and restriction of movements are noted.
• In later stages, the joint is severely deformed, the shin is sometimes curved and takes an X-shaped or O-shaped shape.

The diagnosis is made on the basis of the survey, survey data and the results of additional studies. A decisive role in the diagnosis and determination of the degree of arthrosis is played by the x-ray of the ankle joint.

About arthrosis is indicated by the narrowing of the joint gap, the growth of the edges of the joint surfaces (osteophytes). In later stages, cystic formations and osteosclerosis of the subchondral (located under the cartilage) zone of the bone are revealed.

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In complex cases, the patient is additionally referred to an ankle joint for a more accurate assessment of the bone structure of the patient, for soft tissue examination - on the ankle joint MRI.

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If necessary, to identify the cause of arthrosis and differential diagnosis with other diseases appoint consultations of related specialists: neurologist, rheumatologist, endocrinologist, etc.

Conservative therapy for arthrosis of the ankle

Treatment of arthrosis of the ankle joint is long, complex. Usually patients are observed in the trauma unit. During an exacerbation, hospitalization in the department of orthopedics is possible.

The most important role in slowing the progression of arthrosis is played by the lifestyle and the correct mode of motor activity, so the patient is given recommendations for weight reduction and optimization of the load on the leg.

A complex of therapeutic physical training is designed, taking into account the manifestations and stages of the disease. The patient is referred to physiotherapy.

Drug therapy is also selected taking into account the symptoms and stage of the disease. During an exacerbation, non-steroidal anti-inflammatory drugs are prescribed: indomethacin, meloxicam, diclofenac.

The funds of this group have a negative effect on the mucous membrane of the stomach, so with digestive diseases systems or appoint "sparing" medications (celecoxib, nimesulide), or use an external NSAID, in the form of ointments.

Along with anti-inflammatory drugs, local anesthetics are recommended in the form of ointments and gels.

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In severe pain syndrome, which can not be stopped with the help of medications, perform intraarticular blockades with corticosteroid drugs.

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The administration of corticosteroids should not be performed more than 4 times a year.

All these funds only eliminate pain and inflammation, but do not affect the cause of arthrosis, therefore, along with the listed drugs prescribe the patient chondroprotectors - substances that promote the normalization of metabolic processes in the cartilaginous tissue.

The means of the chondroprotective group are used in the form of creams, gels and preparations for intraarticular administration. They use Synvisc, Ostenil and other medicines containing glucosamine and hydrolyzate of collagen.

To improve local blood circulation and increase tissue metabolism appoint pentoxifylline and nicotinic acid.

Surgical treatment of arthrosis of the ankle

If necessary, surgical treatment is performed: sanation arthroscopy, ankle arthrodesis or endoprosthetics. Sanitary arthroscopy is usually performed with severe pain in the 2 stages of arthrosis.

During the operation, the orthopedist removes from the articular cavity freely fragments of cartilage, osteophytes and other formations that cause pain and impede movements in the joint.

The effect of surgical intervention persists for several years.

With significant destruction of articular surfaces, arthrodesis can be performed - removal of the joint and "splicing" of the bones of the foot and lower leg. As a result, pain disappears, and the supporting function of the limb is restored.

The most effective and physiological operation in the late stages of arthrosis is endoprosthetics - removal of the broken joint surfaces of bones and their replacement with plastic, ceramic or metal prostheses.

Movements after such interventions are restored in full, the life of the prosthesis is 20-25 years.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/ankle-arthrosis

Osteoarthritis of the ankle: causes, symptoms, treatment

Arthrosis of the ankle joint refers to a chronic degenerative dystrophic disease. First, the lesion occurs in the cartilage, then the inflammatory process passes to the joint tissue: bone, capsule, synovial membrane, muscles, ligaments.

The disease develops subsequently traumas, excessive loads, certain inflammatory processes and metabolic disruptions. Sometimes arthrosis can appear without any reason.

Why arthrosis of the ankle arises? What are the treatment methods for pathology?

Description of arthrosis of the ankle

When the disease occurs gradual destructive processes in the surrounding tissues, in the articular cartilage. Pathology proceeds wavy - it then calms down, then becomes aggravated.

In some cases, it begins to actively progress. From the arthrosis of the ankle joint, both women and men suffer.

The risk of developing arthrosis rises with age, although recently they began to diagnose the disease in young people.

Causes of arthrosis of the ankle joint

It is possible to single out the primary and secondary form of arthrosis.

Primary form occurs for no apparent reason, and secondary appears under the influence of various factors - the inflammatory process, trauma, metabolic disorders in the cartilage. The main causes of secondary ankle arthrosis include:

• A major joint injury is a fracture of the ankle, bone, tearing or tearing of the ligaments.
• Constant microtrauma.
• Postponed operation on the joint.
• Excessive strain on the joint. Osteoarthritis can develop with intense sports loads, while staying in a standing position.
• Wearing shoes with high heels.
• Osteochondrosis, intervertebral hernia, in which the nerves are impaired, the muscles of the shins, feet are disrupted.
• Different pathologies associated with disruptions in metabolism - with gout, diabetes, with postmenopause.
• Rheumatoid arthritis.
• Syphilis, tuberculosis, a purulent form of arthritis.
• Genetic predisposition.

How does arthrosis develop?

Each joint surface should be elastic, smooth. Due to the friction of each other, there is amortization under different kinds of loads.

In the event of injury, metabolic disruptions, the cartilage loses its elasticity.

When there is a lack of depreciation, the entire load falls on the bone, in which degenerative processes begin to develop.

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If the arthrosis appeared after the injury, the work of not only bone, cartilage, but also tissues is disrupted.

The synovial membrane and capsule begin to thicken sharply, fibrous degeneration begins in the ligaments. Subsequently, there are problems with the movement of the joint, there is a lot of pain.

In the neglected case, the surface of the joint begins to completely collapse, the person can not move.

Symptoms for arthrosis of the ankle

At first the patient quickly becomes tired, he is disturbed by small pains after heavy loads. Then unpleasant sensations increase.

Pain occurs not only after exercise, but also at night. As a result, the number of movements in the joint decreases, a crunch becomes audible.

At a late stage the patient moves with a cane, a crutch.

There are such basic symptoms of arthrosis of the ankle joint:

• Pain in the ankle appears, even when the person is absolutely calm.
• The pain increases with the load on the joint.
• During the movements, you hear a crunch, clicks, creak.
• When the exacerbation of the joint swells and significantly reddens.
• The joint is unstable, so the patient can often turn his leg, later he has a ligament tearing and stretching.
• Movement bound and limited.

In neglected cases, the joint is completely deformed, the shin begins to bend.

Methods of diagnosis of arthrosis of the ankle

The disease is diagnosed after examination and other studies conducted. Of no small importance is the x-ray of the ankle. If you have arthrosis, the articular gap will be significantly narrowed, osteophytes will start to grow.

At a late stage, a larval formation is diagnosed. In a neglected case, the patient is sent to a CT to examine soft tissues. In addition, it is important to consult a rheumatologist, neurologist, endocrinologist.

Treatment of ankle arthrosis

Conservative treatment course

Most often, the patient is carefully examined by a traumatologist. When the disease worsens, an orthopedic consultation is needed.

First of all, the patient should pay attention to his way of life, daily perform a special set of exercises. Physiotherapy procedures play an important role.

For the treatment of arthrosis, the following methods are used:

• Massage.
• Laser therapy.
• Paraffin.
• UHF.
• Ozokerite.
• Electrophoresis.
• Phonophoresis.
• Magnetic fields.

Medication for ankle arthrosis

• Anti-inflammatory non-steroid preparations - Mawalis, Indomethacin, Voltaren, Diclofenac. Note that this group of drugs has a negative effect on the mucous membrane of the stomach, so they should not get involved.
• Local anesthetics - Finalgon, Fastum-gel, Diklak.
• Chondroprotectors help normalize metabolic processes in the cartilaginous tissue. They are used in the form of gel, cream.

Operation with arthrosis of the ankle

In severe cases, surgical intervention may be required:

• Sanitary arthroscopy - remove osteophytes and cartilaginous fragments that lead to pain. The operation lasts for several years.
• Endoprosthetics consists in removing the joint surface of the bone, replacing it with a plastic, metal or ceramic prosthesis. With this operation, you can completely restore the movement.

So, arthrosis of the ankle is a serious enough disease, which must be paid attention, otherwise everything can end with serious consequences. At the slightest violations it is necessary immediately to undergo a general examination and the necessary course of therapy.

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A source: https://medportal.su/artroz-golenostopnogo-sustava-prichiny-simptomy-lechenie/