Post-traumatic arthrosis of the ankle joint: symptoms and treatment
Post-traumatic arthrosis of the ankle is a disease that is associated with degenerative-dystrophic pathological changes of articular cartilage. Often such a disease is accompanied by inflammation of adjacent tissues.
Probable consequences of the disease
In the absence of proper treatment, pathology can actively regress, thus contributing to the alteration and disruption of the normal operation of one of the most important joints, which is responsible for human mobility.
The ankle joint itself is a joint of the small and large tibia. Blood flow enters the joint through the tibia, and its sensitivity is provided by the branches of the tibial nerves. A useful feature of the joint is its high mobility and the ability to withstand everyday loads within the limits of human weight.
Such common phenomena as banal sprains of the ligaments and the tucking of the legs, may well serve as a symptom of posttraumatic arthrosis of the ankle joint. The presence of this sign indicates that the muscles, in a normal state, stabilizing the joint with the support of the leg, have lost their strength or lack sufficient blood circulation. Completely cure this pathology is very real, if you find it in time and choose the right way to treat it.
If you believe impassive statistics, then six out of a hundred people have a risk of such a form of arthrosis. These people include 20% of the population under the age of 40 and 80% of those older. With such a disease, a woman and a man may face. Most often, the pathology manifests itself at the age of 45-50 years, the earlier arthrosis can be observed in people suffering from obesity.
Causes of the disease
All kinds of bruises, fractures provoke the development of necrotic processes in the tissues near the joint. This is due to circulatory disorders, trauma to the nerve tissue, lowering the muscle tone. All this subsequently causes gradual wear of the cartilage and subsequent deformation of the joint bones.
With age, the blood supply to the joint is significantly slowed down. Gradually, the destruction of cartilage occurs against the backdrop of improperly organized sports activities, age-related mechanical wear and an increase in the viscosity of the synovial fluid. As a rule, the 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 event of permanent trauma to the foot, as well as due to sport damage or severe dislocation. Excess body weight significantly increases the load on the joint, because of which its destruction is accelerated. Another common factor that can affect the development of posttraumatic arthrosis of the ankle joint is the congenital predisposition of a person to diseases associated with the musculoskeletal system.
Basic prerequisites for accelerating pathological processes in bone and articular tissues:
- work providing for permanent exposure to the legs;
- regular wearing of shoes at too high heels;
- alcohol abuse;
- congenital pathologies of joint development;
- all kinds of chronic diseases: for example, varicose veins, arthritis or gout.
Species of pathology
It is very important to identify the symptoms and treatment of posttraumatic arthrosis of the ankle at the initial stage of the disease. Only in this case the treatment of pathology will be maximally effective.
Considering the causes of the disease, several types 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 can not determine the causes of the emergence of primary pathology, especially often this happens when diagnosing arthrosis in adolescents and children.
- Secondary. Such a variety arises from hormonal disorders, metabolic disruptions or chronic diseases. In addition, this group includes damage to the joint.
Degrees of development of arthrosis
Depending on the degree of development of pathology, specialists identify several stages that are characterized by certain diagnostic features.
- Initial. At this stage of the development of the disease, the patient feels pain in the joint after heavy loads, and also notices a slight puffiness in the damaged area. In this case, the X-ray photograph shows a small narrowing of the lumen of the joint space.
- Second. At this stage of the patient's pain the patient has no connection with physical activity. However, during too abrupt movements, the patient hears a distinct creak and crunch of the joint, and in the morning feels the stiffness of the leg. When diagnosing posttraumatic 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 articulation gap is narrowed by at least 40%.
- Third. This stage of arthrosis is characterized by literally unbearable pain in the area of the damaged joint, which can last even a few days in a row. The patient can find a limp, at which the deviation of the shin axis to the left or to the right will be noticeable. During the examination of a patient suffering from posttraumatic arthrosis of the ankle joint of the third degree, a pathological change in the bones, a complete or partial atrophy of the muscles and ligaments, as well as a significant growth of the osteophytes, is detected.
Importance of diagnosing
If posttraumatic arthrosis of the ankle is not detected at the initial stage of development, the pathology will eventually go to the second and third stages, and all can end with disability and total loss of ability to work. Unfortunately, in 90% of all cases of patients, patients seek medical help only at the second stage of development of arthrosis, not paying attention to the initial signs.
In fact, the problem is that the gradual injury to the cartilage does not manifest itself for a long time until the formation of osteophytes causing painful pain begins on its surface. This is how the posttraumatic deforming arthrosis of the ankle 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 the disease
At the initial stage of development, pain in the ankle zone is felt after physical exertion, training, with long walking, running or climbing the stairs.
There are a number of characteristic signs of post-traumatic arthrosis of the ankle:
- stiffness of the muscles in the morning;
- specific creaking and crunching of the joint with sudden movements;
- lack of ability to move without special warm-up;
- clicks when bending feet;
- fast fatigue of the feet;
- swelling in the joint region;
- during exacerbations there is also redness and hyperthermia.
If pathology occurs due to severe ankle injury, palpation of the joint area may experience uneven surfaces, dents or abnormal bulges.
In fact, it is not difficult to identify the disease even at the initial stages of development. To do this, the orthopedist should simply listen and examine the patient, and then get acquainted with the radiographic picture of the foot.
Treatment of post-traumatic arthrosis of the ankle
All methods of treating post-traumatic arthrosis of the ankle are aimed at preventing de-tragic changes in the injured place and the removal of pain.
It is very important to unload the ankle in time, limiting the patient's stay on legs, eliminating the lifting of weights and lowering static loads. The mobility of the joint can be reduced by using special bandages, elastic bandages and bandages. In neglected cases, the doctor can prescribe the patient bed rest, recommending movement with crutches or a cane.
Drug therapy may include:
- preparations-anelhetics "Ibuprofen", "Movalis", "Celebrex", "Voltaren" for elimination of inflammation;
- analgesics-anesthetics "Ultracaine" and "Lidocaine" for topical application;
- glucocorticosteroids "Diprospan" and "Kenalog" for elimination of pain syndrome;
- muscle relaxants and medications that have the sedative effect of "Sirdalud", a tincture of valerian or motherwort for getting rid of muscle spasms and relieving tension;
- chondoprotectors "Alflutop" and "Structum" to prevent further destruction of cartilage, are used as injections or oral preparations;
- ointment "Chondroxide", all kinds of gels and compresses for external use.
Other methods of treatment of
In addition to medication, physiological and physiotherapeutic methods of treatment can be used to eliminate symptoms of the 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 advanced stages of posttraumatic arthrosis of the ankle joint surgery may be required. The joint of bones, as a result of which the joint loses mobility, is called arthrodesis. And endoprosthetics involves replacing the joint with an artificial prosthesis.
Treatment of arthrosis in the early stages is significantly different from therapy in advanced cases.