Arthrosis is a disease with an increasing degeneration of the cartilage in the joint. At the same time there is also an inflammatory reaction with too much fluid in the joint, a burning sensation and pain. The increasing destruction of the joint leads to restricted mobility and reduces the ability to walk.
Causes for arthrosis in the upper ankle joint
Arthrosis of the upper ankle joint is a lot less common than arthrosis of the knee or hip. It is mainly caused by a trauma after injuries or overuse;
What are the symptoms of arthrosis in the upper ankle joint?
Diagnostics of arthrosis in the upper ankle joint
The first step is a clinical examination of the ankle joint. With the help of ultrasound, we can usually find an increased amount of fluid in the joint. The advantage of ultrasound is the fact that the mobility and instability of the joint can be seen and tested.
Based on X-rays it is possible to assess the positioning of the joint when in motion and to show leg axis malalignments. You can see a narrowing of the joint cavity due to reduced cartilage material. Irregularities of the joint surfaces can also be detected.
For the planning of our therapy, an MRI is quite often necessary as well. With the MRI, we can clearly see bone problems (oedema) and injuries of the soft tissue. We can also get a full picture of the cartilage damage in the whole joint.
In addition, a digital walk analysis, certain blood tests or an osteoporosis measurement (osteodensitometry) will provide further useful information.
The conservative therapy of arthrosis in the upper ankle joint
The aim of our arthrosis therapy is; to mitigate the pain while walking, to reduce the inflammation and to improve the functionality of the joint in order to contain the further development of the arthrosis.
In our practice, we use the following therapies;
Surgery as therapy for arthrosis in the upper ankle joint
For minor cartilage damage, floating fragments or a so-called osteochondrosis dissecans, we usually suggest to carry out surgery which will lead to a clear improvement. We use various methods depending on the site of the damage.
During key-hole surgery we insert an arthroscopic camera into the joint. That way we can have a precise look at the defect. For minor defects we use boring or micro-/nano-fracture techniques in the upper bone layer. This results in bleeding that stimulates the bone’s stem cells to form new cartilage. In case of bigger and deep-lying defects, we use membranes that will be inserted into the defect, eventually leading to the growing of cartilage cells. Floating fragments which can be trapped or might be rubbing against the healthy cartilage, will be removed. Any scarred tissue or bony growths (osteophytes) causing damage to the cartilage or restrict the mobility, will also be removed in the same operation.
Depending on the site of the damage open surgery of the ankle joint could become necessary.
Dr. Eva Wörenkämper who is a qualified surgeon for foot and ankle joints will carry out this type of surgery on-site in our clinic RKM 740, followed by a short-term inpatient treatment.
In case of more severe cartilage damage or leg-axis malalignments, there are further possibilities such as ankle joint endoprosthesis or stiffening of the ankle joint (arthrodesis). We do not carry out such surgery. However, we will, of course, offer our expert opinion and help with the preparation and post-operative treatment of such operations.
The post-operative treatment of cartilage damage in the upper ankle joint
Depending on the surgery, scope and position of the defect, you will not be allowed to put any weight on your foot. If only floating fragments, scarred tissue or bony growths are removed, it will probably be possible to use your foot right away.
The post-operative treatment will happen in our practice, or you will see the orthopedic surgeon who referred you to us. The treatment involves regular checks on the wound. The threads can be removed within 12–14 days.
We also offer supporting measures such as cryotherapy, kinesiology taping, acupuncture or osteopathy. Dr. Eva Wörenkämper and her team who are specialists in sports medicine and science, will be very happy to support and guide you regarding the start of your sport activities.
What are the consequences of cartilage damage in the upper ankle joint?
Arthrosis in the upper ankle joint is usually degenerative, eventually leading to the destruction of the joint. It causes pain, swelling, and an increasing restriction of the mobility of the upper ankle joint.
The restricted mobility of the upper ankle joint, especially when lifting the foot, can lead to a shortening of the calf muscles. The different rolling movement of the foot causes an upward chain reaction in the connected bones, i.e., pain in the knee, hip, sacroiliac joint and spine.
It also leads to different strains on the foot possibly causing malpositions of the foot and damage due to overuse (metatarsalgia, fractures and oedema).
What can be done as preventive measures against arthrosis in the ankle joint?
Arthrosis cannot be healed, so that preventive measures are utterly important. It is crucial to avoid injuries to the ankle joint and to determine and treat instabilities or malalignments.
