Exercises
Physiotherapeutic exercises for ankle joint arthrosis should only be carried out in inflammation-free stages. They primarily serve to improve the mobility of the joint. Large, extensive movements continue to improve the blood circulation in the joint, and metabolic waste products can be better removed.
Cartilage is nourished by the alternation of pressure and tension. A physiologically adapted load on the ankle joint is therefore important in order to ensure the optimal supply of cartilage and thus its preservation. A mobilizing exercise is, for example, circling the foot clockwise and counterclockwise.
The movement should be as large as possible. From the pointed foot position, the outer edge of the foot is lifted, followed by the forefoot, the foot circles upwards and is pulled, a slight pulling in the calf may be possible. Now the inner edge of the foot is lifted and the foot is lowered until it reaches the toe position again.
The exercise should fall easily and can be repeated often (about 20 times) in several sets. A common cause of ankle joint arthrosis is joint instability, e.g. after frequent bending or fractures. The ankle bone then does not sit properly in the joint fork consisting of calf and tibia and is not guided securely. Targeted strengthening and coordinative training can eliminate this instability and improve joint function.
Operation
An operation is usually not necessary with good conservative therapy. Even after an operative therapy, conservative follow-up treatment with intensive physiotherapy is necessary to ensure a successful therapy. The aim of the surgical intervention is to restore the congruence of the joints and thus the best possible joint function.
A joint replacement takes place arthroscopically, i.e. minimally invasive. Cartilage abrasion products are removed from the joint and bony attachments that restrict joint mobility are ground down. In addition, drillings can be made to trigger a healing process, cartilage transplants can be carried out, or the position of the joint can be changed by repositioning (repositioning osteotomy) bones, visual attachments and/or ligaments, so that the axis of movement can be influenced and corrected in a targeted manner.
In case of complicated injuries of the joint, a joint replacement may be necessary (endoprosthetic joint replacement). A complete joint stiffening (arthrodesis) can also be useful to make the ankle joint painless and stable in everyday life, even if it loses its mobility. Today, ankle plastic surgery is already improved and more mature than it was some time ago, so that arhtrodesis has to be performed less frequently.