Treatment of ankle arthrosis in Moscow

With arthrosis in the ankle joint, cartilage tissue is quickly destroyed. These are irreversible processes that cause serious complications. Women and athletes are more susceptible to the disease. Due to improper load distribution, this disease can occur. The disease is also caused by bruises, falls, and damage to soft tissues. Overweight people often suffer from arthrosis due to increased stress on the knee joint.

The ArthroMedCenter Joint and Spine Clinic offers its patients a modern effective method for treating ankle arthrosis - MBST therapy, which allows you to restore the affected joint tissues, as well as completely relieve a person from the disease without pain and operations!

Main stages of the disease

Most modern people are faced with inflammatory processes that occur in bone tissue. It is better to familiarize yourself with the symptoms of such diseases in advance in order to promptly recognize the disease and begin treatment with a rheumatologist. The main symptoms manifest themselves in the form of pain, “crunching” when moving, and decreased mobility of the legs. These are also subluxations, the causes of which are disruption of muscle function, changes in tendons, and swelling that manifests itself in the ankle joint. Upon visual examination, in almost all cases of the disease, the tibia axis acquires an X-shaped deformity.

The first stage of the disease proceeds almost unnoticed; the person complains of fatigue. In the second stage, a person feels sharp pain when moving, swelling appears, decreased mobility of the foot, and weather dependence (joints ache when weather conditions change). The third stage is the destruction of articular cartilage. The shock-absorbing properties of the joint decrease, mobility suffers, and a crunch appears. Modern medicine does not guarantee a complete cure, but can slow down the processes that contribute to the destruction of the joint.

Conservative treatment

Most fresh ankle tears and sprains respond well to conservative treatment.
Conservative treatment usually consists of fixing the ankle joint with an orthosis for several weeks, active physiotherapy and exercise therapy.

However, it is known from statistics that a third of patients, despite the treatment, develop chronic instability of the ankle joint.

Instability is often poorly tolerated by the patient, interferes with work and sports, and requires constant wearing of an orthosis.

Long-term ankle instability and repeated subluxations associated with ligamentous incompetence are indications for surgery.

Treatment of ankle arthrosis with MBST therapy

ArthroMedCenter offers exclusive treatment for ankle arthrosis using magnetic resonance therapy. Today, this is the only technique that is incommensurate in effectiveness with traditional treatment and can replace total endoprosthetics.

MBST therapy is based on the phenomenon of magnetic spin resonance, which occurs under the influence of electromagnetic radiation in hydrogen atoms present in living cells. Briefly, its essence, like the treatment of arthrosis itself, comes down to restoring the ability of affected cells to operate with energy, which leads to their restoration and activation of cellular metabolic processes.

The use of a unique non-invasive technique can significantly enhance the processes of cartilage tissue regeneration by blocking the synthesis of inflammatory mediators, suppressing anaerobic cycles and supporting hemostasis within cells. As a result, it is possible to relieve pain, remove restrictions in mobility, improve tissue trophism and, in general, make the treatment of joint arthrosis better and more effective. It is noteworthy that after undergoing magnetic resonance therapy procedures, tissue growth is observed throughout the year.

Using MBST therapy, ArthroMedCenter offers the most effective treatment for ankle arthrosis. Equally important is the comfort and painlessness of the method. Having undergone the required number of sessions prescribed by the center’s experienced specialists after studying the anamnesis, patients with arthrosis can not only improve their quality of life, but also prevent painful and expensive surgery.

The use of advanced technologies allows our center to take the treatment of arthrosis of the knee joint to a completely new, higher quality level, and guarantee the health of our patients.

Causes of ankle pain

Injuries

Pain syndrome is often provoked by trauma (domestic, sports). Traumatic injury occurs from a fall, twisting of the foot, or direct impact. At the moment of injury, the pain is sharp and severe; subsequently, the pain becomes dull. Bruises and abrasions are common. Soreness is accompanied by swelling. The following types of damage are distinguished:

• Bruised ankle joint.
  The most common ankle injury. Occurs due to direct impact - a fall, a kick or a blunt object. Immediately after the injury, the pain is acute and of high intensity, then weakens and becomes dull. Pain sensations are localized at the site of the injury. Restriction of movement is slight or moderate. The bruise can be complicated by hemorrhage into the joint (hemarthrosis), and the pain becomes bursting.
• Sprain and rupture of ligaments.
  Typically, damage to the anterior talofibular ligament is detected as a result of a sharp twisting of the foot. Injury occurs more often during periods of ice. When damaged, intense sharp pain is felt along the anterior outer surface of the ankle. Subsequently, the pain decreases somewhat, local swelling quickly develops, and the damaged area becomes bluish or bluish-purple. Movements are sharply limited, the foot is deviated inward. Walking is possible only with support on the heel.
• Damage to the Achilles tendon.
  Achilles rupture is a professional injury for gymnasts and ballet dancers; it occurs during a jump or when falling from a height. The pain is localized in the back of the ankle, slightly above the heel. At the time of injury, the pain is sharp and very strong. The pain gradually subsides, but persists for a long time. Edema develops quickly. When a rupture occurs, the patient feels a click or crunch of the fibers breaking. There is a marked decrease in the strength of the calf muscle. Plantar flexion is weakened.
• Fractures and fracture dislocations.
  Usually there is an isolated fracture of the ankles or a fracture in combination with a subluxation of the foot caused by twisting of the leg. The pain in the ankle area is acute, excruciating, becomes unbearable with any touch or movement, can radiate to the lower leg, and only slightly weakens over time. On palpation, a crunch and pathological mobility are noted. Bruising is common, spreading to the entire foot and ankle. Support on the leg is impossible. In osteoporosis (in elderly patients, with a number of diseases), the clinical manifestations are smoothed out and resemble a bruise.

Degenerative-dystrophic diseases

Degenerative pathologies of the joint are caused by impaired metabolic processes and microcirculation, which leads to the gradual destruction of cartilage tissue, subchondral areas of bones, and surrounding soft tissue structures. Often accompanied by the formation of bone growths (osteophytes). The course is chronic, slowly progressive. The outcome may be disability due to significant deformation of the foot and limitation of movement. The following types of degenerative processes are distinguished:

• Arthrosis of the ankle joint.
  Osteoarthritis is often detected in older people. In young patients it can develop against the background of previous joint injuries. Initially, aching pain is noted along the front and lateral surfaces of the joint, appearing in the evening or against the background of prolonged exercise, and disappearing after rest. As the pathology progresses, the pain increases, becomes shooting, and occurs at night, at the beginning of movement (“starting pain”). Sometimes you can hear a crunching sound while walking. In the final stage, persistent joint deformation and severe limitation of support and walking are possible.
• Osteochondropathies.
  Damage to the navicular bone of the foot (Köhler's disease I) is usually found in boys 3-7 years old, observed when foci of aseptic necrosis form due to impaired blood circulation in the subchondral areas of the bone. Clinical signs include swelling of the dorsum of the foot, pressing or burning pain in the forefoot and medial part of the foot, aggravated by walking. Lameness with support on the outer edge of the foot is determined.

Inflammatory pathologies

Inflammatory processes in the ankle joint and its ligamentous apparatus are often based on aseptic inflammation due to abnormal load on the ankle (obesity, wearing high-heeled shoes, flat feet, professional sports). In other cases, the etiological factor is the penetration of an infectious agent through damaged skin or blood. The following inflammatory diseases accompanied by pain in the ankle are distinguished:

• Achilles tendonitis.
  Inflammation of the Achilles tendon is often found in people involved in athletics, and sometimes develops due to long-term use of fluoroquinolone antibiotics. At first, the pain in the area of ​​the calcaneal tendon at the back of the ankle is insignificant, has a pulling nature, and only bothers you in the first minutes of exercise. Subsequently, the intensity of the pain gradually increases, it becomes burning and constant. Even a long rest does not bring relief. There is slight local swelling and difficulty moving. A buildup of fibrous tissue may form around the tendon.
• Synovitis.
  Inflammation of the synovial membrane occurs in many acute and chronic pathologies of the joint. In an acute process, the pain is diffuse, bursting, intense, the joint is significantly increased in volume, movements are limited. With chronic synovitis, the pain is weak, aching, occurs gradually, and intensifies as fluid accumulates in the joint. The volume of the joint depends on the amount of effusion.
• Bursitis.
  Achilles bursitis and ankle bursitis are formed under increased loads, injuries, and rheumatic pathologies. Characterized by increasing burning and bursting pain in the back and lateral parts of the ankle, progressive swelling. Sometimes a soft tumor-like formation is palpated. Movements are usually preserved. When infected, the pain intensifies and becomes diffuse. The skin over the bursa turns red, and signs of general intoxication appear - weakness, fever, chills.
• Viral arthritis.
  Arthropathy due to viral infections (measles, chickenpox, hepatitis B, C) usually appears in the prodromal period, preceded by other symptoms - skin rash, jaundice, etc. The joints of the hands, knees, and ankles are symmetrically involved. The pain is moderate, aching, localized on the front surface of the ankle, and does not limit movements. Minor swelling may occur. Arthritis regresses on its own without any treatment and does not leave deformities or contractures.
• Tuberculous arthritis.
  Usually diagnosed in elderly people and children suffering from pulmonary tuberculosis. At first, arthralgia is weakly expressed, does not have a clear localization, bothers the patient only during sudden movements and passes quickly. As tuberculosis progresses, pain increases. The joint gradually swells, the skin becomes hot but does not turn red, and movements are limited. As a result, deformation and contractures are often observed. Arthritis is accompanied by the general clinical picture of tuberculosis – low-grade fever, weight loss, sweating.
• Gonococcal arthritis.
  Occurs in 5% of patients with gonorrhea, mainly in young women. Characterized by asymmetrical damage to the ankles and knees. Migrating aching arthralgias and transient swelling due to inflammation of the tendons and bursae are typical. Ankylosis can develop quite quickly. With massive colonization by gonococci, the pain becomes diffuse, bursting, and the skin over the joint turns red. Arthropathy is accompanied by skin pustulosis and fever.
• Brucellosis arthritis.
  Joint inflammation is the most common manifestation of brucellosis (about 90%). There are symmetrical diffuse aching, nagging pain sensations localized in large joints and the spine. The course of arthritis is wavy. Due to damage to the periarticular tissues (ligaments, tendons), the ankle area swells greatly, and movements in the joint are limited. Sometimes ankylosis develops.
• Purulent arthritis.
  Purulent inflammation of the ankle joint is usually a consequence of an open fracture or osteomyelitis of the distal tibia. Strong, diffuse, throbbing, bursting pain appears. The joint swells, the skin takes on a red tint and becomes hot to the touch. Any movements cause a sharp pain reaction. When a large amount of purulent effusion accumulates, the phenomenon of fluctuation occurs. Symptoms of general intoxication are expressed - fever, chills, weakness.

Rheumatological diseases

Pain in the ankle often indicates the presence of rheumatological pathology. The pathogenesis of such diseases is due to the formation of autoantibodies that attack the body’s own cells, including the cells of the synovial membrane. The distinctive features of diseases of this group are the uncertainty of the etiological factor (the exception is rheumatism), a chronic course with exacerbations and remissions, diffuse pain over the entire surface of the joint, the presence of extra-articular lesions, and a variety of clinical manifestations. The most common rheumatic pathologies:

• Rheumatoid arthritis.
  More common in young women (30-40 years old). It is characterized by a systemic process with symmetrical involvement of several joints (especially the hands), but can also begin from the ankle. Arthralgia is long-lasting, aching, more intense at rest, disappearing approximately an hour after the start of physical activity. Morning stiffness is typical. As the process progresses, the pain intensifies, and persistent joint deformation develops, disabling the patient.
• Ankylosing spondylitis (Bechterew's disease).
  Diagnosed in young men. The spine, sacroiliac joints, large joints, and entheses in the lower extremities are predominantly affected. Pain in the ankle is mild, but constant. The pain is aching, dull, intensifying in the second half of the night and in the morning. Swelling and limitation of movements are practically absent. Uveitis (redness of the eyes, lacrimation, photophobia) is also noted.
• Psoriatic arthritis.
  Associated with a severe skin disease - psoriasis. Typically the development of progressive asymmetric oligoarthritis leading to disability. There is constant aching pain of moderate intensity and slight swelling in the ankle. The skin color is burgundy-bluish. Specific signs are arthritis of the distal interphalangeal joints, nail damage (pinpoint depressions, dystrophy of the nail plates, onycholysis). Localization of psoriatic plaques is the scalp, elbows, knees, intergluteal folds.
• Rheumatic fever.
  Arthritis is considered the main symptom of rheumatism. Short-term arthralgias are characteristic, occurring approximately a week after acute streptococcal infection of the upper respiratory tract. The joints become enlarged due to swelling, and movement is limited. The pain is aching, nagging, of moderate activity, migrates (passes from one joint to another). The inflammation is benign and resolves quickly without any residual effects. Almost always accompanies rheumatic carditis.
• Reactive arthritis (Reiter's syndrome).
  The main reason is recent urogenital (chlamydia, mycoplasmosis) or intestinal infections (shigellosis, dysentery). Often seen in young people. There is asymmetrical damage to the lower extremities (joints, tendons, entheses). The severity of arthritis has a wide range - from minor wave-like to constant unbearable pain with severe swelling. The process is prone to chronicity with an unfavorable outcome. Sacroiliitis is typical. Arthritis is accompanied by urethritis and conjunctivitis.
• Collagenoses.
  The group of diffuse connective tissue diseases includes systemic lupus erythematosus, systemic scleroderma, and dermatomyositis. They are united by a variety of clinical presentations, involvement of the skin, internal organs, and joints (including ankles). Arthritis often comes to the fore and is the initial sign of the disease. Arthralgia is usually symmetrical, with moderate aching pain, passes quickly, does not limit movement, is not accompanied by swelling, and does not lead to deformities.
• Inflammatory bowel diseases.
  Sometimes ankle pain indicates inflammatory bowel disease (Crohn's disease, ulcerative colitis, Whipple's disease). Typical is spondyloarthritis, asymmetric arthritis of the knees and ankles with minor aching migrating pain. There is no restriction of movement. The degree of arthralgia correlates with the activity of intestinal inflammation. Deformation does not develop. Along with arthropathy, the clinical picture includes enteritis, iridocyclitis, and erythema nodosum.

Systemic metabolic disorders

In some diseases, increased production or decreased utilization of certain substances leads to the accumulation of various proteins or metal ions in internal organs and joints. This group of pathologies is distinguished by hereditary nature or the presence of a predisposition, a wide range of clinical signs, a progressive course, and resistance to therapy (with the exception of gout). Pain in the ankle may be accompanied by the following metabolic diseases:

• Gout.
  It is caused by increased formation and decreased excretion of uric acid, which leads to its accumulation in the tissues of the joints. It proceeds in fits and starts. A gout attack is triggered by eating fatty foods and alcohol. The pain is sharp, burning, bursting, sometimes unbearable. The joint is swollen, the skin over it is hot. Tophi on the skin are possible. The attack is accompanied by fever and chills. There are no symptoms during the interictal period.
• Amyloidosis.
  Characterized by the deposition of a special fibrillar amyloid protein. Inflammation of the joints is usually destructive and proceeds similar to rheumatoid arthritis - with morning stiffness, arthralgia of several joints, aggravated by rest and relieved by movement. A distinctive feature of pain in amyloidosis is its higher intensity at night. The outcome is almost always deformation. Neuropathies, renal, and heart failure also occur.
• Hemochromatosis (bronze diabetes).
  In hemochromatosis, chondrocalcinosis develops due to the deposition of calcium pyrophosphate. Arthropathy can occur gradually with “mechanical” arthralgia, as in osteoarthritis, or in the form of acute arthritis, reminiscent of gout. The skin becomes dark brown or bronze in color. Due to hormonal disorders, baldness, diabetes, and hypogonadism occur. 30% of patients are diagnosed with liver cancer.

Tumors and tumor-like diseases

A fairly rare cause of ankle pain is tumors or tumor-like formations. The pain is usually diffuse and has no connection with motor activity. Pain syndrome can be caused by benign synovial villous hyperplasia, cartilaginous metaplasia, aggressive tumor growth, and, less commonly, metastatic damage to joint tissue. The following pathologies are identified that are accompanied by pain in the ankle area:

• Benign neoplasia.
  Synovial chondromatosis, pigmented villonodular synovitis. Typically one joint is involved. Development is gradual. The pain is dull, not intense, and progresses slowly. Sometimes a hard formation can be felt in the joint area. Young men are more often affected.
• Malignant neoplasms.
  This group includes synovial sarcoma, chondrosarcoma, and metastases from other organs. The pain is increasing, diffuse, severe, debilitating, can spread to the lower leg, is accompanied by severe restrictions on movement, and correlates with tumor growth. Arthralgia can also occur as a manifestation of paraneoplastic syndrome, in which the body responds to the growth of a malignant tumor by producing antibodies that attack joint tissue. In such cases, damage to one or more joints is possible, such as reactive or rheumatoid arthritis.

Treatment of ankle arthrosis

There are several methods for getting rid of arthrosis. As a rule, complex treatment of not advanced forms of the disease using conservative methods is used: drug treatment, physiotherapeutic procedures, gymnastics, lifestyle correction.

In cases where arthrosis is severe, it is customary to use surgical treatment methods, namely:

1. Minimally invasive intervention (puncture). A needle is inserted into the joint to withdraw fluid. This is more of a diagnostic method that allows you to obtain material for research, administer corticosteroids to the site of inflammation, and reduce the load on the capsule.
2. Arthroscopy is the transfusion of a professional apparatus with a sensor through microscopic incisions in the skin to examine the ankle joint or remove separated fragments of cartilage tissue. This method can eliminate the inflammatory process and pain.
3. A periarticular osteotomy involves filing down the patient’s bones and then securing them at a different angle. Surgery can reduce the load on the joint and relieve pain for a long period of time. This type of operation is rarely used, since the burden on the body of a patient of any age is a risk. A long recovery period also plays a role. Periarticular osteotomy is very effective, but it is used only in extreme cases.
4. Endoprosthesis replacement is used when other types of treatment for ankle arthrosis have proven ineffective. When the disease has destroyed the joints, they are replaced with special plastic or metal prostheses. Sometimes ceramic dentures are used. This is a complex operation that requires considerable financial costs. Another disadvantage of this method of treating ankle arthrosis is the long rehabilitation period and the patient may experience pain for six months. Despite all the disadvantages, endoprosthetics is the only alternative treatment for a patient at an advanced stage. The prosthesis needs to be replaced after twenty years. All these years a person can live a normal life, forget about pain and inflammation.

All conservative methods of treating arthrosis are, of course, quite effective, however, each of them carries with it some discomfort for the patient. Speaking about surgical intervention, it is worth noting long-term rehabilitation. Today, there is a more modern and comfortable way to treat arthrosis of the ankle joint - MBST therapy, which has been popular abroad for many years. Now innovative treatment is available to patients of our Clinic!

Moscow, metro station Dubrovka, st. Sharikopodshipnikovskaya, 6/14