Diagnostics

Already in the anamnesis valuable hints can be collected.In addition, previous injuries to the ankle joint or inflammatory joint diseases can provide evidence of ankle arthrosis. Imaging techniques are used for precise diagnosis:

Such are pain characters,
Pain intensity and
Time of pain often a good indication.
Especially x-rays in two planes under load allow a good assessment of the joint. Often a narrowed joint space can be seen here.
This indicates abrasion of the articular cartilage and thus an already existing arthrosis. Malposition of the joint or bony outgrowths as a sign of degeneration, which can hinder the joint, are also clear indications of ankle arthrosis.
In order to assess the joint cartilage and possible damage to tendons or ligaments, an MRI of the foot is necessary. This procedure is primarily used to assess the damage accurately, but not only for diagnostic purposes.

Therapy

To be able to take the correct measures in case of ankle joint arthrosis, the disease should be diagnosed first. If typical symptoms of ankle joint arthrosis occur, it is advisable to consult a physician, who can diagnose the joint disease after a comprehensive diagnosis and expand therapy options. It is also advisable to consult an orthopedic specialist in addition to the family doctor treating the patient, since doctors in this specialty are the specialists in the field of diagnostics and therapy of ankle joint arthrosis.

Once the ankle joint arthrosis has been diagnosed, conservative treatment methods are usually used at the beginning of the therapy. These include in particular physiotherapy and the wearing of special ankle joint bandages or insoles. These therapies can often prevent or at least slow down the progression of the disease.

It is important to regularly perform the exercises recommended by the doctor or physiotherapist to ensure the effectiveness of these measures. It should also be noted that an existing ankle joint arthrosis does not result in a ban on sports. A lack of exercise can even promote the progression of the disease.

Rather, it is important to perform the correct form of exercise and thus improve the course of the disease. The symptoms that occur can also be treated therapeutically, which is why complaints arising from ankle arthrosis should never go untreated. Another possibility to treat the arthrosis is by injecting hyaluronic acid into the joint space.

Whether hyaluronic acid therapy is appropriate for the individual patient is best assessed by the treating physician. If conservative measures do not bring success, the doctor can be asked about the possibility of carrying out surgery. Depending on the cause for the occurrence of arthrosis, different procedures can be used.

In addition to a stimulation of the cartilage, a transplantation of cartilage tissue can also be performed, which can alleviate the symptoms and prevent the disease from progressing.

Ankle arthrosis can be treated conservatively with special insoles. These consist of a sole roll or an arthrodesis boot, which provide pain relief and improve function.
The sole roll supports the rolling movement during walking, which is often restricted in the initial stages of arthrosis. The arthrodesis boot stabilizes the ankle joint and provides external support. Both orthopedic aids can significantly alleviate pain in the early stages and improve mobility.
In some cases, anterior new bone formations (osteophytes) can be milled off.
If they are not removed, they can gradually damage the cartilage through the abrasion of the joint surfaces and destroy the joint space. The removal improves mobility and also relieves pain. Furthermore, the progression of arthrosis can be significantly slowed down.
If the joint cartilage is already very degenerated, it can be cultivated in the laboratory and re-inserted into the patient’s remaining cartilage.
The cartilage then grows back into the bone and stimulates the surrounding cartilage tissue to proliferate (grow). Alternatively, membranes can be used to promote the ingrowth of new cartilage cells. However, these procedures are only suitable if part of the cartilage is still intact.
In case of a very pronounced arthrosis with complete loss of cartilage surface, the upper ankle joint can be replaced by an artificial joint.This allows the mobility of the ankle joint to be maintained.
If the artificial joint loosens after a few years, a new joint can be inserted. If this is not possible, or if there was no other possibility before, the ankle joint can be stiffened. The destroyed cartilage is completely removed and then the ankle bone is firmly screwed to the shin bone.

After about 6 to 12 weeks, the bones have grown together stably and the foot can be loaded again with almost no restrictions. Due to the great mobility in the lower ankle joint and the metatarsal bone, the stiffening can be partially compensated and thus leads to a loss of pain without restricting mobility too much. However, it is possible that the stiffening leads to an additional load on the other joints (knee joint, hip joint, spine). These are put under much greater strain due to the loss of mobility in the upper ankle joint and can then also show degenerative changes after a few years. Nevertheless, stiffening is a very good alternative that significantly increases the quality of life if the other therapeutic methods are not possible or do not bring success.