Treatment of ankle joint arthritis abroad
Ankle joint pain exists under constant high stress. The body weight is directed at the joints while walking. This causes frequent inflammation in the joints which results in arthritis. Arthritis develops in elderly people in 80% of cases. Illness leads to disability in 20% of cases.
Causes of the ankle joint arthritis
Arthritis of the ankle joint is a pluricausal disease. This means that the inflammation could be caused by a whole number of various factors:
- Injuries of the ankle
- Infections that develops directly in the tissues of the ankle joint
- Metabolic disorders with an increased level of uric acid, accompanied by salts in the tissues of the ankle (gout)
- Systemic autoimmune inflammation of the connective tissues characterized by the formation of antibodies to the body's own tissues (eg,rheumatoid arthritis, rheumatism)
- Specific infections when the disease spreads and infect the tissues of the ankle joints and affect them (eg, tuberculosis, syphilis)
- Anatomical foot defects, which often have congenital origin and lead to a functional stress on the ankle (flat feet)
- Some infections in the respiratory and urinary system, when the reactive inflammation of the ankles develops
- Blood infection (sepsis) with the spread of microorganisms throughout the body and their subsidence in various organs, tissues, including the ankle joint
All cases of ankle joint arthritis are divided into the primary and secondary depending on the type of damage and the cause.
Probability of secondary joint inflammation is significantly increased under the influence of the trigger factors which are related to:
- Local hypothermia (overcooling)
- Considerable physical activity
- Weakened immune system
Modern European healthcare centres are equipped to find the exact cause of ankle joint arthritis as an obligatory measure to further choose the best therapeutic tactic possible.
Symptoms of arthritis in the ankle joint
There are several peculiar clinical signs that point towards the development of the inflammation in the ankle joint:
- Skin redness in the area of the affected joint
- Increase of the local temperature of the inflamed tissues (foot area feels hot when touched)
- Swelling of the soft tissues is the result of fluid accumulation inside the tissue
- Pain in the ankle joint usually increases when you move it
- Increased volume of the joint itself
- Dysfunction of the joint accompanied by the restricted mobility and lameness
- General body intoxication with low-grade fever, malaise, decreased work capacity
Depending on the number of the affected joints they differentiate between:
- Monoarthritis means only one joint is affected
- Polyarthritis means the nearby joints of the foot are involved in the pathological process
Ankle joint arthritis can also be bilateral (a frequent sign of a systemic connective tissue pathology) and one-sided (it develops against the background of joint infections, its trauma or gout).
Diagnostics of ankle joint arthritis
Objective diagnostics of ankle joint arthritis includes an exact cause of the inflammatory process and also how strong the disorders are manifested.
There are several techniques applied to reach the goal:
- Visualisation of the ankle tissues using radiography, computer tomography or magnetic resonance imaging
- Joint ultrasound determines the volume of the accumulated synovial fluid in its cavity
- Special functional tests performed to find out how the movement disorders are manifested
- Laboratory blood tests done to determine the markers of the autoimmune inflammatory process
- Joint puncture is performed to take the synovial fluid sample from its cavity for subsequent laboratory examination
- Detection of infections determining the antibodies in the blood to the main pathogens
The volume of diagnostic procedures is determined by the type of arthritis, as well as by the capabilities of the healthcare institution.
Modern German hospitals are equipped with all the necessary skills and tools necessary for a complete and qualitative diagnosis of arthritis of the ankle joint.
Treatment of arthritis in the ankle joint abroad
Ankle joint arthritis depends on the severity of tissue changes and a cause of inflammation. They normally refer to the 2 therapeutic approaches as:
Conservative therapy includes medicines of various pharmacological groups that make it possible to exclude the further impact of the causative factor and reduce the severity of the inflammation. Physiotherapy, massage, therapeutic exercises, intra-joint injections of hyaluronic acid are done as well.
Surgical treatment is performed in different ways depending on the origin of the illness, its clinical course, degree of joint damage and they include:
- Arthroscopy is done when an arthroscope is inserted into the joint and a doctor can see the ankle from the inside. Fragments of bone and cartilaginous tissue, blood clots, salt deposits are removed under the control of an arthroscope. This reduces the symptoms. Nevertheless, the effect will be temporary and will last at least several years for the course of the chronic disease.
- Orthopedic endoprosthetics is a radical method of treatment, when an artificial prosthesis is installed instead of the patient’s own ankle joint. Today's prostheses are of high quality, so the patient is able to retain working capacity.
Innovative treatment of arthritis in the ankle joint
A lot of techniques are known today to restore the joint’s surface. Techniques are high-tech so are not easily available everywhere. However, German hospitals offer such services for their citizens or medical tourists.
One of the effective therapies, which delays, and sometimes avoids arthroplasty of the ankle, is the transplantation of autologous chondrocytes. They are taken from the joint, and then cultivated in the laboratory to increase their amount. Cartilage cells are applied to a 3D matrix, which replaces a defect of the cartilaginous tissue in the ankle joint.
Implantation of matrix-induced autologous chondrocytes requires two arthroscopic operations: the first for the extraction of cartilaginous tissue, the second for the implantation of an autologous (own, genetically native) cartilage. The effect of the operation is good for 5-10 years. How innovative is that?!
Prognosis for ankle joint arthritis
Ankle joint arthritis is not a name of a separate illness. This is a term meaning presence of the inflammatory process. Prognosis is determined by a major disease. Conservative treatment brings success in some cases. Other pathologies lead to the ankle joint destruction, violation of its function and chronic pain which might require prosthetics in the end.