Ankle arthrosis is a chronic degenerative-dystrophic disease. First of all, cartilage is affected, over time; the pathological process covers all joint tissues: the capsule, synovial membrane, bones, ligaments, and adjacent muscles. The cause of development can be trauma, developmental disorders, excessive stress, inflammatory diseases, and metabolic disorders. In some cases, the disease occurs for no apparent reason. It is manifested by limitation of movement and pain in the joint.

Arthrosis has a chronic undulating course with alternating remissions and exacerbations and gradually progresses. Women and men suffer equally often. The likelihood of development increases dramatically with age. At the same time, experts note that the disease is “getting younger” – every third case of arthrosis of the ankle joint is currently detected in people under 45 years of age.

Reasons for development

 There are two groups of arthrosis: primary and secondary. Primary arthrosis occurs for no apparent reason. Secondary develops under the influence of some unfavorable factors: trauma, inflammation, etc. In both cases, the basis is a violation of metabolic processes in the cartilaginous tissue.

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

• Major joint injuries (fractures of the ankles and talus, tears, and ruptures of the ligaments).
• Constant microtrauma.
• Ankle surgery.
• Excessive workload: too intense sports activities, long walking or standing in a standing position due to working conditions, etc.
• Wearing shoes with heels.
• Diseases and conditions associated with metabolic disorders (diabetes mellitus, gout, pseudogout, lack of estrogen in postmenopausal women, etc.).
• Rheumatic diseases (SLE, rheumatoid arthritis).
• Osteochondrosis of the lumbar spine, intervertebral hernias, and other conditions, which are accompanied by nerve entrapment and disruption of the muscular system of the foot and lower leg.

Less commonly, nonspecific purulent arthritis, arthritis with specific infections (tuberculosis, syphilis), and congenital malformations become the cause of arthrosis. An unfavorable environmental situation and hereditary predisposition play a certain role in the development of arthrosis.

Development mechanism

 Normally, the articular surfaces are smooth and elastic. They slide freely relative to each other during movement and provide effective cushioning under load. As a result of mechanical damage (trauma) or metabolic disorders, the cartilage loses its smoothness, becomes rough and inelastic. Cartilage “rub” during movement and more and more injure each other, which leads to the aggravation of pathological changes. Due to insufficient shock absorption, the excess load is transferred to the underlying bone, and degenerative-dystrophic disorders also develop in it: the bone is deformed and grows along the edges of the articular platform.

Due to secondary trauma and disruption of the normal biomechanics of the joint, not only cartilage and bone suffer, but also the surrounding tissues. The joint capsule and synovial membrane thicken, foci of fibrous degeneration are formed in the ligaments and periarticular muscles. The ability of the joint to participate in movements and withstand stress decreases. The joint becomes unstable, contractures occur, pain syndrome progresses. In severe cases, the articular surfaces are destroyed, the supporting function of the limb is impaired, and movements become impossible.

Ankle arthrosis symptoms

 First, there is rapid fatigue and mild pain after a significant load. Subsequently, the pain syndrome becomes more intense. The pain appears not only after exercise but also at night. A visible deformation is gradually formed; the range of motion in the joint decreases, and a crunch is heard during movements. In the later stages, movements are sharply limited, support becomes difficult, and when moving, patients are forced to use crutches or a cane.

Distinctive features of pain syndrome and other symptoms in arthrosis:

• Starting pains are characteristics that occur after a state of rest, and then gradually disappear with movements.
• There is an increase in pain during exercise and rapid fatigability of the joint.
• When moving, crunching, squeaking, or clicking sounds may occur.
• Night pains usually appear in the morning.
• During an exacerbation, the joint area may be swollen and reddened.
• Due to the instability of the joint, the patient often twists the leg, sprains, and tears of the ligaments occur.
• Stiffness and limitation of movement are noted.
• In the later stages, a pronounced deformation of the joint is revealed, the lower leg is sometimes bent and takes an X-shaped or O-shaped shape.

Diagnosis of ankle arthrosis

Orthopedic examination

Ankle ultrasound

MRI of the ankle

Ankle arthrosis treatment

Drug therapy

Physiotherapy: Magnetotherapy on a stationary Italian device “Magnetotherapy PMT QS”.

Ultrasound therapy on an ultrasound device “Sonoplus 490” (Holland) providing deeper penetration of drugs.

High-tone therapy: The latest development of German scientists is a unique 2-channel device “Hi-Top 2 touch” (Germany).

Light therapy with the apparatus “Bioptron” (Switzerland), which has a polychromatic incoherent effect, creating polarized light.

Oxygen therapy through the joint puncture.

Intra-articular administration of chondroprotectors.