Osteoarthritis is a disease characterized by progressive destruction of articular cartilage and proliferation of the pathological process in the whole joint that eventually leads to its complete immobilization. Osteoarthritis is more common in the elderly, they suffer more than half of people older than 60 years.
Ankle osteoarthritis, symptoms and treatment of which is discussed in this article are relatively rare, but the resulting dysfunction of the musculoskeletal system are among the most heavy.
Ankle osteoarthritis has other names: osteoarthritis, deforming osteoarthritis, deforming osteoarthritis (DOA). To understand the mechanism of its development, consider the structure of the joints.
To ensure the mobility of the joints of the bones and their connecting parts have the same shape and are covered with a thin layer (0.2-0.5 mm) smooth cartilage. To reduce friction of articular cartilage when the joint is surrounded by a sealed by the synovial membrane, filled with liquid acts as a lubricant, and feed the tissue. On top of the synovial membrane the joint is protected by a strong joint capsule, to the outer layer which are attached ligaments and tendons of the muscles that control the articulating bones.
The ankle joint is a connection between the talus bone of the foot with tibia and fibula bones of the lower leg that cover it on both sides like a fork.
The development of osteoarthritis begins with the fact that due to different reasons: genetic, trauma or metabolic disorders, in the tissues of the articular cartilage degenerative changes occur. First, it changed the composition of the synovial fluid, then on the articular cartilage defects appear gradually ulcerate the surface, the thickness of the cartilage covering the bone is reduced until their complete destruction. The articulating surface of the bones thicken and thicken at their edges appear growths – osteophytes limiting mobility. All these processes are accompanied by pain and reduced physical activity. With disease progression the joint fully loses its function, pathological changes also occur in the tendons and muscles.
Modern methods of treatment of osteoarthritis of the ankle joint allow to slow down its development, and in severe cases to perform surgical operation on the joint replacement endoprosthesis.
There are primary and secondary osteoarthritis.
Secondary osteoarthritis is usually the result of injury or illness, endocrine, infectious, autoimmune, causing inflammatory and degenerative processes in the joints.
Primary osteoarthritis develops without previous injury and disease can provoke this disease. His appearance can be caused by strain due to obesity or abuse of sports training, genetic predisposition, congenital defects of the joints.
The main reasons for the development of osteoarthritis of the ankle joint are:
Most often deforming arthrosis of the ankle joint develops as a result of injuries.
Injuries cause primary damage to the cartilage tissue, resulting in inflammation develops, which can trigger the development of osteoarthritis.
The second most frequent cause of osteoarthritis of the ankle is a congenital condition, called dysplasia of the ankle joint. This deviation appears during fetal development.
At an early age applied methods of its correction, but the discrepancy between the rubbing surfaces of the mating bones may remain, resulting in uneven abrasion of the articular cartilage and causes the development of arthrosis of the ankle.
In the development of secondary osteoarthritis of the ankle significant role of inflammatory processes in the tissues, caused by various diseases. These diseases can be:
In addition to these reasons, the development of osteoarthritis of the ankle joint also contribute to the degenerative changes in his cartilage, associated with the elderly and senile age.
Symptoms of osteoarthritis of the ankle joint depend on the degree of development of the disease and have the following characteristic manifestations:
The symptoms of osteoarthritis of the ankle are similar to symptoms of other diseases of the joints, so it is very important to pass a comprehensive diagnosis of musculoskeletal system for accurate diagnosis. During the examination, the doctor prescribes a common biochemical analysis of blood, determination of the level of CRP, uric acid, rheumatoid sample.
The most informative methods to see the condition of the bones of the ankle – radiography in two projections, ultrasound, CT, MRI.
They allow us to estimate the size of the gap between the talus bone and the bones of the lower leg, presence of osteophytes, shape and sizes of interfaced surfaces of bone, and on this basis to determine the stage of osteoarthritis of the ankle.
There are 3 stages of osteoarthritis of the ankle.
Osteoarthritis of 1 degree of the ankle joint in the radiograph are not defined. Pathological changes concern mainly the synovial membrane and synovial fluid, nourishes the cartilage. Disorders of the ankle yet.
May experience such symptoms as the appearance of crunch movements and the decrease of the resistance of the ankle joint to the usual load.
The degree of arthrosis 2 ankle joint is characterized by the appearance of starting pain, aching pain at night and pain when walking. With the deepening of the pathological process becomes chronic pain, edema, seizures, begins the deformation of the joint, reduced range of motion of the ankle can begin atrophic changes in the joint capsule, ligaments and muscles.
Radiograph shows reduction of the gap between articulating bones due to thinning of the articular cartilage. Around the perimeter of the bone surfaces appear in small amounts bone growths – osteophytes.
The osteoarthritis grade 3 ankle joint is the most difficult stage. Its characteristic feature is a change in the axis of the joint due to the strong deformation of the reference surface of the bones. Develops instability of the ankle joint due to weakened ligaments or a sharp restriction of mobility due to growths of bone tissue. Pain become chronic and require constant intake of painkillers, there is atrophy of muscles and other tissues of the lower leg.
Striking characteristic is the offset of the Central axis of the ankle from its anatomically correct position.
The final stage of osteoarthritis of the ankle joint is characterized by the development of ankylosis is complete immobility. In this case the fixation of the ankle occurs, as a rule, in its physiological not entirely disruptive of the limb.
Deforming osteoarthritis of the ankle joint typically develops slowly. From the appearance of initial symptoms to severe dysfunction of the ankle, resulting in disability, it takes several years.
Early treatment helps to slow down the pathological process and to minimize its painful symptoms. For this purpose, many methods of treatment and prevention, which are aimed at:
For the relief of pain and inflammation in osteoarthritis of the ankle are widely used nonsteroidal anti-inflammatory drugs. In the acute phase of the inflammatory process inside the joint is injected with injections of corticosteroids, strong anti-inflammatory and analgesic effect.
To accelerate the regeneration of cartilage appoint chondroprotectors, which can be both oral and by intramuscular and intra-articular injection. For imposing inside joints also used hyaluronic acid, which in its composition is identical to synovial fluid, thereby providing cartilage nutrition.
One of the modern methods for the treatment of pain and inflammation in tarso., affected by osteoarthritis – laser therapy. It is no less effective than injections of corticosteroids, and thus has much less side effects.
One of the most important conditions for the preservation of the functionality of the ankle affected by osteoarthritis, is the preservation of optimal physical activity. Soreness of the joints forcing patients to limit their movements, which leads to atrophy of the ligaments and muscles, and further exacerbates the problem. It is therefore important to understand the need for physical activity. During exacerbation of osteoarthritis it is necessary to provide tarso. rest, but once pain syndrome resolved within 1-2 days is possible to start the motor load.
Food for osteoarthritis of the ankle joint must, on the one hand, to satisfy the body's need for nutrients, minerals, vitamins and minerals, and on the other contribute to getting rid of excess weight, if any. After all, excess weight gives increased load on the ankle, and bringing it back to normal can significantly slow down the development of osteoarthritis.
It is recommended to eliminate from the diet all products which have no nutritional value – sugar, confectionery, flour and pasta, sausage, etc. Eat more fresh greens, vegetables, berries, fruits, lean meats, oily fish, dairy products. Try to frequently eat food containing collagen, jellied meat and fish, jellies based on gelatin, marshmallows, marmalade.
In the treatment of osteoarthritis of the ankle joint have an important place physiotherapy. As shown by the large-scale survey conducted by the American Agency for health care quality, most effective methods of physiotherapy in osteoarthritis are: massage, warm up, rhythmic joint mobilisation.
To take care of the health of your joints is necessary for all, but especially for those who are at risk for osteoarthritis of the ankle, is listed under "risk Factors." It is important to recognize the increased risk of developing the disease, and the appearance of the slightest symptoms of osteoarthritis: the crunch in the joints, pain during movement and after exercise, consult with an orthopedist.
To reduce the risk of developing osteoarthritis will help the following preventive measures:
We would like to emphasize the role of footwear in the development of osteoarthritis of the ankle joints. You run the risk of suffering osteoarthritis of the ankle if: