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It develops gradually, inevitably progresses, causes pain, limits movements to the point of the inability to perform even basic actions - all this is about arthrosis. Unless, of course, it is treated. Forget about prostheses and injections - in the clinic of Dr. Oleg Savyak you will receive modern, painless and conservative therapy according to the best European canons !
Clinical picture of the disease
The ankle joint is composed of two ankles, articular ligaments and talus bones (tibia and fibula).
When an inflammatory process develops in the articular cartilage, arthrosis is diagnosed. The pathological process leads to tissue destruction, thinning of cartilage and a decrease in its strength.
In the process of inflammation, bone formations grow, which leads to ankle deformation.
According to the international classification of diseases, ankle arthrosis is assigned the ICD-10 code M19. The disease develops suddenly under the influence of predisposing factors.
At the earliest stages, there is no symptomatic manifestation; incipient pathological changes can only be detected by x-ray. Over time, the signs of arthrosis will intensify as the degree of inflammation increases. The advanced form of the disease becomes a cause of disability.
Stages and forms
Arthrosis of the ankle can be primary or secondary. In the first case, the disease develops independently in an initially healthy joint, in the second, it is a consequence of trauma to the cartilage or a complication of another disease associated with it. Based on its origin, arthrosis is divided into several categories:
- Post-traumatic – caused by ankle injury
- Dysplastic – caused by undiagnosed and untreated dysplasia
- Static – resulting from a disproportionate division of the load on the joints over a long period of time
- Post-inflammatory – occurring during acute or chronic inflammation of cartilage
Depending on the location, arthrosis can develop on the right ankle or on the left. Most often, bilateral pathology is diagnosed. The disease occurs in 3 stages.
Stage 1 is characterized by an asymptomatic course of pathology in bone tissue. At stage 2, the deformities are more pronounced, and pain appears in the affected area. At the final stage, an exacerbation of all symptoms occurs, contributing to the loss of joint mobility. It is at this stage that the likelihood of becoming disabled is high.
Degrees of arthrosis of the ankle joint
The most widely used classification is that of Kellgren and Lawrence:
- Zero stage. There are no signs of arthrosis.
- First stage. The radiograph raises doubts among the doctor. Darkening is visualized in places of tissue changes.
- Second stage. The image shows minimal changes in the structure of the joint.
- Third stage. Signs of pathology are pronounced and are clearly visualized on an x-ray. Changes in cartilage and bone are determined.
- The material is sent for analysis for differential diagnosis with inflammatory arthritis, gout, and infection.
Reasons for development
The most common factor in the development of ankle arthrosis is uneven long-term load distribution.
That is why people who are overweight and athletes are most often at risk.
- Arthrosis, unspecified (M19.9)
The disease also appears due to incorrect alignment of joint surfaces.
The resistance of cartilage to physical stress is affected by injuries, arthritis and diabetes.
The active ability of the joint decreases, and the inflammatory process begins.
In women, a prerequisite for the development of arthrosis can be called the wrong choice of shoes. By giving preference to high heels, they expose the ankle joint to the development of disease.
Articular cartilage, under the influence of such factors, becomes thinner, cracks, loses its plasticity and can completely collapse. Medicine knows cases of “receiving” arthrosis by inheritance.
What is arthrosis and how does it manifest?
This is a degenerative-dystrophic disease that is chronic in nature (not to be confused with arthritis - an inflammatory process). The cartilage is primarily affected. The blood supply is disrupted, the tissue becomes thinner. At later stages of development, bone growths appear - deformation.
At first, the discomfort appears more in the morning and during movement, then the pain persists even when the person is at rest. In advanced cases, muscles and other joints suffer.
Symptomatic manifestation
At a very early stage, the disease occurs without visible changes in the ankle and general well-being. As the stage of development of arthrosis increases, the manifestation of symptoms intensifies. The general clinical picture may look like this:
- When sitting for a long time or leaning on the sore leg, a short-term feeling of stiffness occurs, which disappears a few minutes after the start of movement.
- When applying a load, the pain in the joint intensifies.
- When moving, a crunching, clicking or squeaking sound is heard.
- There is some stiffness of movement.
- The axis of the lower leg is bent.
- Atrophy occurs in the muscles adjacent to the injured area.
- The joints may become swollen.
- The temperature of the feet increases.
- Subluxations occur more often.
As the disease progresses, some symptoms become more pronounced, and the discomfort becomes unbearable. Immediate medical attention is required to avoid complications or complete destruction of the cartilage.
Complaints and symptoms
Complaints in case of damage to the rotator cuff include pain in the shoulder joint, increasing when the arm is abducted to the side, crunching, clicking when moving the shoulder joint, lack of abduction in the shoulder joint.
The disease begins with pain in the shoulder joint, then, as a result of inflammation, softening of the tendons of the rotator cuff muscles and bone tissue of the attachment site of these muscles occurs, as a result of which the muscles can tear or a complete separation of the muscle occurs with the formation of a cosmetic defect, such as separation of the long head of the biceps or separation of the supraspinatus muscle, which will lead to loss of abduction function and persistent contracture of the shoulder joint.
Treatment method for ankle arthrosis
After X-raying the ankle and confirming the diagnosis, the doctor will prescribe the most appropriate course of treatment.
This takes into account the patient’s general health, the stage of development of the disease, its type and the presence of concomitant pathologies.
- Arthrosis of the ankle joint - symptoms and treatment
The main areas of therapy are:
- Pain relief
- Elimination of inflammation symptoms
- Establishing blood circulation and nutrition of the affected area
- Restoring joint mobility
The treatment method for each patient is determined individually. In some cases, surgery is the only option.
Drug therapy
When treating at home, drugs are used that have different rates of action: fast and slow. The first group is used for symptomatic treatment, the second is necessary for the restoration of cartilage and affected tissues.
To relieve pain and prevent further inflammation, Ibuprofen, Diclofenac, Naproxen, Aceclofenac, Nimesulide, Acetaminophen are prescribed orally or as an ointment.
Most of them negatively affect the condition of the gastric mucosa, so their long-term use is not recommended.
Slow-acting medications help restore properties and improve the synthesis of cartilage tissue. These include Arthrodarin, Teraflex, Artra, Alflutop, Structum. They contain chondroitin, hyaluronic acid and glucosamine necessary for the affected area.
The photo shows an x-ray of arthrosis
Manual therapy
Therapeutic massage sessions will help strengthen the muscles of the lower leg and foot. The work starts from the toes and moves upward to the lower leg and thigh. The session takes no more than 20 minutes. The duration of the course is determined by the attending physician.
The most optimal solution is 3 repetitions of the procedure over 2 weeks with breaks between each of about 14 days. Self-massage of the ankle joint is less effective.
- Deforming osteoarthritis (osteoarthritis) - description of the disease and treatment methods
Physiotherapy
Physiotherapeutic procedures are prescribed with the aim of dilating blood vessels and normalizing the flow of blood and lymph. For arthrosis of the ankle joint, magnetic therapy is considered the most commonly prescribed manipulation. The impact on the affected area is 2-3 times throughout the day.
In the photo, exercises to strengthen the ankle
Orthopedic products
When diagnosing ankle arthrosis, it is recommended to wear orthopedic shoes or use orthosoles, half-insoles or special correctors.
Such devices allow you to relieve the load from the joint, relieve pain and optimize the position of the shin axis. The height of the outer or inner edge of the shoe allows you to correct the resulting deformation.
An ankle orthosis can also be used to fix the correct position of the foot. It is used both during treatment (during exacerbation of the disease) and to prevent injuries at home or while playing sports.
Pictured are orthopedic products
Gymnastics and exercises
Gymnastics for arthrosis is aimed at maintaining and restoring muscle tone and increasing joint mobility. At the initial stage of training, the loads are minimal so as not to aggravate the course of the disease. Exercise therapy helps strengthen the immune system and improve metabolism in the body, which will increase the delivery of oxygen and nutrition to the affected areas. The starting position of all exercises performed is lying down. They can be performed at home or on an outpatient basis under the supervision of a specialist.
For arthrosis of the ankle joint, it is useful to alternately rotate the feet in both directions. Having completely relaxed and stretched out on the floor, turn your ankle first towards yourself, then away from you. The amplitude of movements should be insignificant.
Surgery
If there is a threat of cartilage destruction or conservative therapy is ineffective, surgical intervention is required. The final stage of the disease can only be treated through surgery. There are several types:
- Arthroplasty (allows you to completely preserve the joint)
- Arthrodesis (the joint is closed artificially, but remnants of cartilage are preserved)
- Endoprosthesis replacement (the diseased joint is completely replaced with a prosthesis)
Artificial material is not always well accepted by the body, because for it it is a foreign body.
Prostheses are made of metal, ceramic or plastic. Their service life does not exceed 25 years. During this time, the patient is provided with complete restoration of mobility.
Prevention and prognosis
To prevent the development of ankle arthrosis, you should eat a balanced and healthy diet, avoid injury and promptly treat any inflammatory diseases. Regular physical activity with an even distribution of effort is allowed.
It is impossible to completely get rid of arthrosis, but it is quite possible to achieve a long period of remission with the help of drugs and folk remedies. At the same time, do not forget to follow the rules of disease prevention and control your body weight. excess weight is an additional burden not only for joints, but also for the functioning of internal organs.
Reviews about the treatment of ankle arthrosis, see our video:
In ICD-10, the term “Post-traumatic osteoarthritis” is considered a nosological synonym for the diagnosis Unspecified Arthrosis (M19.9).
Why does ankle arthrosis occur?
Arthrosis is in most cases the lot of older people. However, in recent years the disease has become younger and appears in patients under 45. The most common causes:
- injuries and microdamages;
- ankle surgery;
- excess weight;
- heavy load: long standing, playing sports;
- constantly wearing high heels;
- hereditary predisposition;
- sedentary lifestyle;
- gout, diabetes mellitus, osteochondrosis (as provoking factors).
Active substances related to code M19.9
Below is a list of active substances related to ICD-10 code M19.9 (names of pharmacological groups and a list of trade names associated with this code).
- Active ingredients
- Aminophylline + Diphenhydramine + Indomethacin
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Amtolmetin guacil
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds - Bovhyaluronidase azoximer
Pharmacological group: Enzymes and antienzymes - Valdecoxib
Pharmacological group: NSAIDs - Coxibs - Hyaluronic acid
Pharmacological groups: Correctors of bone and cartilage tissue metabolism, Regenerants and reparants - Hydrocortisone
Pharmacological groups: Glucocorticosteroids, Ophthalmic drugs - Glucosamine + Chondroitin sulfate
Pharmacological group: Correctors of bone and cartilage metabolism in combination with other drugs - Dexamethasone
Pharmacological groups: Glucocorticosteroids, Ophthalmic drugs - Dexketoprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Diclofenac + Misoprostol
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Diclofenac + Pyridoxine + Thiamine + Cyanocobalamin
Pharmacological groups: Vitamins and vitamin-like drugs in combination with other drugs, NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Dimethyl sulfoxide
Pharmacological group: Dermatotropic agents - Bile
Pharmacological group: Local irritants - Ibuprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Indomethacin
Pharmacological groups: Ophthalmic drugs, NSAIDs - Acetic acid derivatives and related compounds - Ketoprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Ketoprofen lysine salt
Pharmacological group: NSAIDs - Propionic acid derivatives - Cat's claw bark extract
Pharmacological group: General tonics and adaptogens - Lidocaine + Tolperisone
Pharmacological group: n-cholinergics (muscle relaxants) in combination with other drugs - Mabuprofen
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Meloxicam
Pharmacological group: NSAIDs - Oxicams - Meloxicam + Chondroitin sulfate
Pharmacological groups: Correctors of bone and cartilage tissue metabolism in combination with other drugs, NSAIDs - Oxycams in combination with other drugs - Methylprednisolone
Pharmacological group: Glucocorticosteroids - Naproxen
Pharmacological group: NSAIDs - Propionic acid derivatives - Naproxen + Esomeprazole
Pharmacological groups: Proton pump inhibitors in combination with other drugs, NSAIDs - Propionic acid derivatives in combination with other drugs - Nimesulide
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Niflumic acid
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Capsicum fruit extract
Pharmacological group: Local irritants - Prednisolone
Pharmacological group: Glucocorticosteroids - Salicylamide
Pharmacological group: NSAIDs - Salicylic acid derivatives - Tenoxicam
Pharmacological group: NSAIDs - Oxicams - Tolperisone
Pharmacological group: Drugs affecting neuromuscular transmission - Tolperisone + Lidocaine
Pharmacological group: n-cholinergics (muscle relaxants) in combination with other drugs - Phenylbutazone
Pharmacological group: NSAIDs - Butylpyrazolidines - Celecoxib
Pharmacological group: NSAIDs - Coxibs - Etoricoxib
Pharmacological group: NSAIDs - Coxibs
Home > ICD-10
Post-traumatic arthrosis of other joints
ICD-10 International Classification of Diseases M00-M99 Diseases of the musculoskeletal system and connective tissue M00-M25 Arthropathy M15-M19 Arthrosis M19 Other arthrosis
M19.1
Post-traumatic arthrosis of other joints
Post-traumatic arthrosis OBD Diagnosis / disease Post-traumatic arthrosis of other joints Diagnosis / disease code M19.1 Standards of medical care for diagnosis / disease M19.1 See Full explanation of the ICD code M19.1: ICD code M19.1 / International Classification of Diseases / Diseases of the musculoskeletal system and connective tissue / Arthropathy / Arthrosis / Other arthrosis / Post-traumatic arthrosis of other joints