Cartilage damage in the ankle joint is not uncommon, which is not surprising when you consider that the ankle joint has to carry the entire weight of our body day after day and is additionally stressed when standing and walking. The cartilage tissue covers all bone parts within the ankle joint and thus practically serves as a shock absorber and a kind of sliding layer, since it is able to absorb and redirect pressure. As a result, damage to this cartilage leads to limited joint function and sometimes to pain, which may be absent because the cartilage tissue is poorly supplied with nerves.
Cartilage baldness describes the condition when there is no cartilage left. In order to better classify cartilage damage to the ankle joint, the classification according to Outerbridge is used, which differentiates between grades 0 to 4. This damage itself is not called arthrosis, but if left untreated, it can often lead to secondary arthrosis in the further course of the disease.
- Grade 0: no existing cartilage damage;
- Grade 1: the cartilage is completely preserved, but softens under pressure;
- Grade 2: the cartilage is slightly roughened on the surface;
- Grade 3: the cartilage is torn up to the bone;
- Grade 4: the cartilage is completely lost down to the bone
Cartilage damage using the knee as an example
Causes
Factors that promote the development of cartilage damage in the ankle joint include obesity (because the joint is then permanently subjected to a higher load), incorrect loading (for example in conditions such as splayfoot) or long-term additional loading from certain sports such as soccer or extreme sports, which are also associated with an increased risk of injury. In contrast to other joints, cartilage damage in the ankle joint is mainly caused by injuries. A typical trigger is the ankle’s outward twisting (a so-called supination trauma).
This causes the cartilage on the inside of the ankle joint to be extremely compressed. This can lead to damage of varying degrees, from slight pinching to tears in the cartilage, which in the worst case can be accompanied by detachment of cartilage tissue and/or bone fractures. A bone spur (osteophyte) on the front of the tibia can also cause damage to this tissue by rubbing on the cartilage of the ankle joint. It is also possible that the increased pressure at this point can trigger a so-called impingement syndrome.
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