Post-traumatic arthrosis of the ankle joint is a disease that is associated with degenerative-dystrophic pathological changes in the articular cartilage. Often such a disease is accompanied by inflammation of adjacent tissues.
The likely consequences of the disease
In the absence of proper treatment, pathology can actively regress, thus contributing to the modification and disruption of one of the most important joints, which is responsible for human mobility.
The ankle joint itself is a joint of the small and tibia. The blood flow enters the joint through the tibial arteries, and the branches of the tibial nerves provide its sensitivity. A useful feature of the joint is its high mobility and the ability to withstand everyday loads within the limits of human weight.
Epidemiology
Such common phenomena as banal sprains and tucking of the legs may well serve as a symptom of post-traumatic arthrosis of the ankle joint. The presence of this symptom indicates that muscles, in the normal state, stabilizing the joint while supporting the legs, have lost strength or lack sufficient blood circulation. It is quite possible to completely cure this pathology if you detect it in a timely manner and choose the treatment method correctly.
If you believe the dispassionate statistics, then six out of a hundred people have a risk of this kind of arthrosis. These people include 20% of the population under the age of 40 years and 80% of those older. A woman and a man can face such a disease. Most often, the pathology manifests itself at the age of 45-50 years, earlier arthrosis can be observed in people suffering from obesity.
Causes of the disease
All sorts of bruises, fractures provoke the development of necrotic processes in the tissues near the joint. This happens due to circulatory disorders, trauma to nerve tissue, and a decrease in muscle tone. All this subsequently causes gradual wear of the cartilage and subsequent deformation of the bones of the joint.
With age, the blood supply to the joint slows down significantly. Gradually, the destruction of cartilage occurs against the backdrop of improperly organized sports, age-related mechanical wear and tear, and increased viscosity of synovial fluid. As a rule, pathology is accompanied by the growth of bone osteophytes and a decrease in the mobility of the entire foot.
In youth, the same processes can occur in the case of permanent injury to the foot, as well as due to sports damage or severe dislocation. Overweight significantly increases the load on the joint, because of which its destruction is accelerated. Another common factor that can affect the development of post-traumatic arthrosis of the ankle joint is considered to be a person’s innate predisposition to diseases associated with the musculoskeletal system.
The main prerequisites for accelerating pathological processes in bone and articular tissues:
- work involving permanent standing;
- regular wearing shoes with too high heels;
- alcohol abuse;
- congenital pathologies of joint development;
- all kinds of chronic diseases: for example, varicose veins, arthritis or gout.
Varieties of pathology
It is very important to identify the symptoms and treatment of post-traumatic arthrosis of the ankle at the initial stage of the disease. Only in this case, the treatment of pathology will be most effective.
Given the causes of the development of the disease, several varieties of the disease are distinguished.
- Primary. The main reason is the mechanical wear of the cartilage against the background of age-related changes or increased loads. Sometimes specialists cannot determine the causes of the appearance of the primary pathology, especially often this happens when diagnosing arthrosis in adolescents and children.
- Secondary. This kind of variety occurs due to hormonal disorders, metabolic malfunctions or chronic diseases. In addition, this group includes joint damage.
The degree of development of arthrosis
Depending on the degree of development of the pathology, specialists distinguish several stages that are characterized by certain diagnostic signs.
- Initial. At this stage of the development of the disease, the patient feels pain in the joint after heavy exertion, and also notices slight swelling in the damaged area. In this case, a small narrowing of the lumen of the joint space is visible in the x-ray image.
- The second one. At this stage of the disease, the patient’s pain is in no way associated with physical activity. However, during excessively abrupt movements, the patient hears a distinct creak and a crunch of the joint, and in the morning he feels his legs stiff. When diagnosing post-traumatic arthrosis of the ankle joint of the 2nd degree with the help of an X-ray, significant changes in the cartilage are revealed, and the joint gap is narrowed by at least 40%.
- The third. This stage of arthrosis is characterized by literally unbearable pain in the damaged joint, which can last even several days in a row. The patient may become lame, in which there will be a noticeable deviation of the axis of the leg to the left or right. During the examination of a patient suffering from post-traumatic arthrosis of the ankle joint grade 3, pathological bone change, complete or partial atrophy of the muscles and ligaments, as well as significant overgrowth of osteophytes are detected.
The Importance of Diagnosing
If post-traumatic arthrosis of the ankle joint is not detected at the initial stage of development, the pathology will eventually pass into the second and third stages, and everything can end with disability and complete disability. Unfortunately, in 90% of all cases of the disease, patients seek medical help only at the second stage of the development of arthrosis, not paying attention to the initial signs.
In fact, the problem is that a gradual trauma to the cartilage for quite some time does not manifest itself until the formation of osteophytes, which cause excruciating pains, begins on its surface. This is how post-traumatic deforming arthrosis of the ankle joint appears, which can be treated conservatively only in exceptional situations. So therapy with this type of arthrosis implies, as a rule, surgical intervention.
Symptoms of ailment
At the initial stage of development, pains are felt in the ankle zone after physical exertion, training, with long walking, running or climbing stairs.
There are a number of characteristic signs of post-traumatic arthrosis of the ankle joint:
- stiff muscles in the morning;
- specific creak and crunch of the joint with sudden movements;
- lack of ability to move without a special workout;
- clicks when bending the leg;
- fatigue of the legs;
- swelling in the joint;
- during exacerbations, redness and hyperthermia are also observed.
If the pathology appeared due to serious damage to the ankle, then on palpation of the joint area, surface roughness, dents or abnormal bulges can be felt.
In fact, it is completely easy to identify the ailment even in the initial stages of development. To do this, the orthopedic surgeon should simply listen and examine the patient, and then familiarize himself with the radiological image of the foot.
Treatment of post-traumatic arthrosis of the ankle joint
All methods of treatment of post-traumatic arthrosis of the ankle joint are aimed at preventing degenerative changes in the injured place and eliminating pain.
It is very important to unload the ankle in time, limiting the patient's stay on the legs, eliminating heavy lifting and lowering static loads. Joint mobility can be reduced by using special dressings, elastic bandages and bandages. In advanced cases, the doctor can prescribe a patient bed rest, recommending movement with crutches or a cane.
Drug exposure
Medication therapy may include:
- analgesic drugs "Ibuprofen", "Movalis", "Celebrex", "Voltaren" to eliminate inflammation;
- Anesthetics "Ultracain" and "Lidocaine" for local use;
- glucocorticosteroids "Diprospan" and "Kenalog" to eliminate pain;
- muscle relaxants and medicines with the sedative effect of "Sirdalud", tincture of valerian or motherwort to get rid of muscle spasm and relieve tension;
- chondoprotectors "Alflutop" and "Structum" to prevent further destruction of cartilage, are used as injections or oral preparations;
- Chondroxide ointment, all kinds of gels and compresses for external use.
Other treatments
In addition to drug exposure, hardware and physiotherapeutic methods of treatment can be used to eliminate the symptoms of pathology:
- irradiation with ultraviolet or laser, as well as magnetotherapy to relieve muscle spasm and prevent their atrophy;
- treatment involving the use of electromagnetic fields to eliminate inflammation and pain;
- electrophoresis and phonophoresis;
- manual therapy, massage and acupuncture;
- thermal sessions in the form of paraffin baths, mud baths, bromine and radon lotions.
In the advanced stages of post-traumatic arthrosis of the ankle joint, surgery may be required. The connection of bones, as a result of which the joint loses mobility, is called arthrodesis. And endoprosthetics involves replacing a joint with an artificial prosthesis.
The treatment of arthrosis in the early stages differs significantly from therapy in advanced cases.