Manifestations and treatment of ankle ankylosis. Disease ankylosis of the joints Ankylosis of the hip joint treatment

Ankylosis is a pathological condition manifested by partial or complete immobility of joints with fixation of osteochondral elements in a certain position. A person loses the main basic function of making movements with a specific joint. Treatment of ankylosis is a complex issue. The prognosis depends on many factors.

Ankylosis is the fusion of the surfaces of the elements that form the joint. Today, this pathological condition is positioned as an irreversible form of disability. Depending on which joint was affected, a person actually loses one or another skill, the ability to move normally, work, and perform certain actions.

Joint ankylosis cannot be eliminated conservatively; fusion cannot be eliminated by pharmacological products, exercises, or physiotherapeutic techniques. Even surgical intervention will only allow the articular elements to be placed in a position that will be most comfortable for the patient.

The only option that can somehow improve the patient’s quality of life is surgery with endoprosthetics. In some situations, an artificial joint can be installed.

In order to navigate the key aspects of the treatment of this complex disease, it is necessary to study in detail the etiological factors, clinical picture and other important nuances.

Causes of ankylosis

First of all, you need to consider what ankylosis is from the perspective of etiology, having examined in detail all the reasons leading to the development of such a condition. Most experts classify fusion of articular surfaces as a certain type of complication. In fact, ankylosis is the next stage of degenerative-destructive changes in bone and cartilage tissues, developing on the basis of other pathologies.

We are talking about the following diseases:

Classification of ankylosis

Joint fusion can be different. The main classification is based on what tissue is formed in the areas of immobilization. Pathological conditions may be the following:

• Bone ankylosis (a true form of pathological fusion of articular elements);
• Fibrous ankylosis (scar type of pathological condition);
• Cartilaginous ankylosis (congenital type of immobility).

The pathological process can completely or partially immobilize the elements of the joint. The surfaces can be joined together, both inside the joint itself and outside it (peripheral type of fusion).

Also, joint ankylosis can be comfortable or uncomfortable. A functionally advantageous position allows a person to live more comfortably with an immobilized joint. A functionally disadvantageous position is an absolute indication for surgical intervention.

Clinical picture

The main symptom is lack of movement in a particular joint. At the very beginning of the pathological process, only stiffness in movements can be observed.

Other important signs:

By the nature of the pain and the degree of stiffness, one can also judge the structure of the pathological tissues that led to immobilization. Fibrinous ankylosis is accompanied by severe pain. A person experiences discomfort constantly.

In this case, even total healing of the joint will allow you to perform oscillatory movements. The bone type of fusion is not accompanied by pain, but also does not allow movement (at least partially).

Dysfunctional manifestations in various forms of ankylosis

If the shoulder is fused in abduction, this type of ankylosis is positioned as a functionally advantageous type. At the same time, the function of the joint to adduct and abduct the limb is preserved. If fusion occurs in the abduction position, this is an inconvenient option for the patient. The limb will not move.

In the case of ankylosis of the hip joint, there are also different positions. Fusion of a straightened limb with slight abduction is considered functionally advantageous and relatively practical. If the joint is in a bent position and is in an abducted state, then this position is considered disadvantageous. The patient will have to use crutches.

If ankylosis of the ankle joint has formed with the foot positioned at a right angle, then the patient will be relatively comfortable.

If the fusion is formed during plantar flexion, this leads to abnormal lengthening of the foot and serious problems while walking.

Diagnostic measures

With the problem of ankylosis, contact a traumatologist or surgeon. As a rule, the disease can be identified at the stage of preliminary consultation and initial examination.

The goals of further diagnosis are to establish the main etiological factors, as well as the nature of the lesion.

The main measures that can be prescribed to patients with suspected ankylosis:

Treatment of ankylosis can be conservative or surgical. A specific scheme of influence on the patient is developed taking into account the needs of each patient, the severity and course of the disease.

Basics of conservative therapy

The main mission is to restore joint mobility, improve trophism of bone elements, help accelerate regenerative processes in cartilaginous structures, and also combat discomfort and pain.

To do this, a combination of therapeutic exercises, manual manipulation and medication is used.

In this case, non-steroidal anti-inflammatory drugs, analgesic drugs and hormonal products are injected directly into the joint space. Electrophoresis, SMT and UHF will help to enhance the pharmacological power of medications.

Treatment of true ankylosis

For true ankylosis, surgical treatment is indicated. There are several intervention options:

Contraindications for surgery

Despite the fact that surgery is sometimes the only way to help a person, there are situations when radical measures have to be abandoned. Main contraindications to surgical intervention:

1. High level of danger of relapse of the disease (including one of the concomitant ailments) immediately after surgery;
2. Complete atrophy of the muscle tissue;
3. Extensive scar tissue changes.
4. The presence of purulent exudate in a partially healed joint space.

Conclusion

Ankylosis is a serious complication of common pathologies of the musculoskeletal system.

To avoid disability and lead an active lifestyle that is not associated with constant discomfort, it is important to promptly diagnose and treat all pathological conditions.

As a result of many injuries or diseases of the musculoskeletal system, ankylosis develops. This is a condition accompanied by impaired motor function and pain in the involved joint. It is caused by fusion of bone articular surfaces or pathology of muscles and tendons located nearby. Subsequently, stiffness of the joint occurs, after which the possibility of movement in it disappears.

Ankylosis can develop in any joint, but most often it affects: ankle; elbow; temporomandibular; knee; brachial; finger joints.

Hereditary factors.

Some gene mutations lead to increased activity of young bone cells - osteoblasts. In this case, the processes of bone tissue formation begin to prevail over its normal destruction, which is accompanied by the growth and fusion of the articular surfaces of the bones. Cases of such diseases occur in families.

Ankylosis can appear after severe joint injury or bone fracture. One of the risk factors for pathology is hemophilia. In this condition, blood clotting is impaired, and one of its frequent manifestations is hemarthrosis - hemorrhage into the joint cavity. Repeated accumulation of blood in the joint capsule leads to inflammation and the formation of excess connective tissue. Gradually, fibrous areas are replaced by bone fusion.

The cause of ankylosis can be joint diseases, such as rheumatoid arthritis or osteoarthritis. The inflammatory process on the surface of the joint leads to the destruction of the synovial membrane, underlying cartilage tissue and bone. Subsequently, connective tissue grows and fusion occurs in the joint cavity.

Infectious arthritis.

Infectious arthritis is one of the causes of ankylosis

Inflammation leads to damage to joint tissue, changes in the composition of synovial fluid and stiffness. Impaired blood flow causes gradual degeneration of the joint and decreased mobility.

Immobility.

Lack of movement in any part of the body can be complicated by ankylosis. This occurs during prolonged immobilization with plaster or in severe illnesses accompanied by immobility of the patient (for example, the consequences of a stroke in the form of paralysis). Ankylosis can also occur in patients who use wheelchairs due to the inability to move.

Classification

There are 2 types of ankylosis: bone and fibrous. Usually fibrous precedes the development of bone.

Bone ankylosis

Fusion of bone surfaces occurs. The joint cavity is filled with bone tissue. The joint becomes completely immobile. In case of incomplete fusion of bones, they speak of partial bone ankylosis. An x-ray reveals a partially or completely closed joint space.

Bone ankylosis. Deformed processes and all bone growths are removed. The free lower jaw is then brought into correct position through skeletal traction.

Fibrous ankylosis

In the joint cavity, rough connective tissue grows between the surfaces of the bones, tightly connecting the bone areas. However, the fibers are not as strong as bones, so minor movements (rocking) in the joint are possible. Irritation of connective tissue fibers by the rubbing surfaces of bones causes chronic pain. The radiograph shows an indistinct, intermittent joint space.

Symptoms

The disease may be accompanied by the following symptoms:

• joint pain;
• inability to bend a limb;
• immobility in the joint;
• signs of inflammation in the involved area - redness of the skin, increased local temperature.

When the joint between the temporal bone and the process of the mandible is affected, patients are concerned about additional signs:

• clicking sounds when opening and closing the mouth;
• difficulty opening the mouth;
• inability to speak or eat without effort.

Signs

In the early stage of the pathology, there is pain when moving the joint, there is morning stiffness, when the patient needs to “work out” the limb. Swelling and redness of the skin often appears. Then gradually all these signs disappear.

The leading sign of ankylosis is difficult or absent movement in the joint. The remaining manifestations of the disease are determined by the position in which the limb is fixed. In particular, with flexion ankylosis of the leg at the knee, the patient cannot walk. If the joint is “stiff” in a straight or slightly bent position, the patient moves without much difficulty.

With the fibrotic variant, the ability to move to a small extent in the affected joint is often retained, but this form of damage is accompanied by pain. With the bone variant, movement is impossible, but there is no pain.

When the temporomandibular joint is damaged, a displacement of the chin, changes in the bite, atrophy of the masticatory muscles, inflammation of the gums, and accelerated deposition of tartar are observed. If the disease began in childhood, a shortened, underdeveloped jaw is formed during growth, and the face is deformed.

Pathology of the shoulder joint sometimes remains unnoticeable for a long time, because the range of motion is compensated by the scapula. This is one of the most common types of pathology.

Disease of the knee joint occurs after severe injury or arthritis. If the limb is fused at an angle of 180°, it will be uncomfortable to lean on. The optimal position of the shin relative to the thigh is an angle of 170°.

Arthritis of the knee joint is a possible cause of ankylosis

Damage to the hip joint often complicates the course of tuberculosis or necrosis of the femoral head. It is accompanied by a change in gait, but in most cases the person is able to move independently.

Prevention

It is impossible to prevent the occurrence of ankylosis caused by a genetic mutation. In all other cases, measures must be taken to prevent this complication:

Diagnostics

The basis for recognizing ankylosis is imaging techniques, such as x-rays of bones and joints, computed tomography or magnetic resonance imaging. With their help, narrowing and discontinuity of the joint space or its complete fusion are determined.

Ultrasound is used to clarify the anatomical features of the joint. It helps to assess the condition of not only bones, but also cartilaginous surfaces, ligaments, and joint capsule.

To determine signs of inflammation, a blood test is used to determine ESR and leukocytes. Their increase indicates acute pathological changes in the joint. When the process of ankylosis formation is completed, there are no changes in the blood.

For differential diagnosis with other articular pathologies, it is necessary to determine the amount of uric acid in the blood. This helps in diagnosing gout. Biochemical analysis with determination of urea and creatinine levels makes it possible to exclude joint stiffness due to chronic renal failure.

Treatment of ankylosis

This disease can be eliminated through proper long-term treatment. Physical therapy, medications, and exercise therapy can help relieve pain and reduce joint stiffness. A properly designed exercise program can gradually increase the range of motion in a sore joint. Yoga classes are very useful.

The main methods of conservative treatment:

• rhythmic muscle contractions if the limb is in a cast;
• manual therapy;
• massotherapy;
• anti-inflammatory and analgesic external agents and tablets;
• injections of glucocorticoid hormones into the joint;
• physiotherapeutic methods - electrophoresis, UHF, magnetic therapy.

In more severe cases of ankylosis, surgery is used - arthroplasty. During this procedure, doctors separate abnormal fusions of the bone and surrounding tissue. Synthetic pads are installed inside the joint to restore movement in it. In modern orthopedic hospitals, arthroscopic arthroplasty is used. This operation allows you to restore mobility in the joint by introducing miniature instruments into the joint cavity without incisions or trauma to surrounding tissues. This significantly improves the outcome of treatment.

In some situations, it is necessary to remove the entire ankylosed area and undergo endoprosthetics. When fusion of bones occurs in an awkward position, an osteotomy is performed - dissection followed by fixation in a functionally advantageous position.

Prosthetics are widely used for ankylosis of the temporomandibular joint; this helps to fully restore its function. In the future, the patient can open his mouth, talk, and eat without difficulty.

After the operation, a course of physiotherapy and exercise therapy is prescribed.

The outcome of the disease is favorable in most cases. After completing the course of treatment, patients return to normal life. If ankylosis is not treated, there is a danger of more severe complications, primarily tendinitis (inflammation of the tendons) and dislocations in the joints.

Joint health– the key to an active, fulfilling life. Their coordinated work provides us with the opportunity to walk, sit, work, do our favorite things and do simple self-care. What will happen to the human body if its joints lose mobility? This condition is called ankylosis. It is characterized by overgrowing of the space between the cartilages with bone or fibrous tissue. In this case, the joint becomes immobile, which leads to partial or complete loss of human performance.

Symptoms

It is quite simple to detect the manifestation of ankylosis: you need to listen to your body. If you feel difficulty moving your joints, if flexion and extension of your limbs does not occur fully or causes pain, then rush to consult a doctor.

In this case, ankylosis can manifest itself differently depending on its type. For example, the fibrous form is characterized by the presence of pain in the joint, but partial preservation of motor function. That is, you can, for example, swing your sore leg, but it will cause you suffering. Bone ankylosis will not cause any discomfort, but the joint will become completely immobile. You shouldn’t let the situation get to this point: it’s better to seek medical help in a timely manner, at the very beginning of the problem.

The joint freezes in the position in which the internal tissues have fused. In appearance and sensation, this resembles manifestations of contracture (that is, restrictions on motor activity as a result of tightening of tissues, muscles, tendons, etc.). But these diseases have different causes and treatment methods, and only a specialist will be able to understand the etiology of your illness.

In order to make a correct diagnosis, the doctor will refer you to undergo magnetic resonance imaging and x-rays. This will determine the condition of the joints and connective tissues.

Causes

What can trigger the filling of the interarticular space with bone and connective tissue? Experts identify several main causes of joint ankylosis:

• purulent infections in the joint - acute or chronic;
• inflammation of the joints (including arthritis, arthrosis, bursitis, etc.);
• injuries (including dislocations and fractures) with hemorrhage into the joint cavity;
• forced prolonged immobility of joints, for example, after surgery;
• birth injuries.

At risk are people who lead a very active or, conversely, too passive lifestyle, as well as those who suffer from autoimmune pathologies. Injuries, heavy load on the joints, keeping the body in one position for a long time - all this can trigger the development of ankylosis. Pensioners, athletes, heavy physical labor workers, and overweight people most often suffer from this disease.

Classification of ankylosis

Ankyloses vary depending on what tissue fills the interarticular space. According to this parameter, three types of disease are distinguished:

1. Fibrous ankylosis characterized by fusion of joints due to connective tissue. In this case, the joint space remains visible, but it is filled with scar adhesions. Partial mobility is preserved.
2. Bone ankylosis makes the joint immobile due to bone fusion of the joints. The joint space disappears with this type of disease. In this case, extra-articular bone ankylosis occurs when the muscles and other soft tissues surrounding the joint become fused. With this type of disease, the joint space is preserved.
3. Cartilaginous ankylosis usually occurs with abnormal intrauterine development of the fetus. It is caused by defects in the formation of cartilage or bone tissue. In this type of disease, the joint space is preserved, as is partial mobility of the joints.

According to the degree of joint fusion, ankylosis is divided into complete (with total loss of mobility) and partial (with preservation of some motor functions). Moreover, in the absence of proper treatment, partial fusion can become complete as a result of disease progression. Since joint immobility can be caused by tissue fusion in various places, intra-articular, extra-articular and capsular ankylosis are divided. Also, ankylosis can be classified into beneficial (when the joint freezes in a position that is comfortable for a person) and disadvantageous.

Which joints are susceptible to ankylosis?

Since there are more than 200 bones in the human skeleton, and many of them are connected to each other by joints and cartilage, the location of the disease can be very diverse. The most common ankylosis of the following joints is:

• Ankylosis of the hip joint. It usually occurs as a result of previous tuberculosis or forced prolonged immobility. In the first case, it will be impossible to get rid of the disease, because surgical intervention can provoke a recurrence of the infectious disease. This type of ankylosis is considered beneficial when fusion occurs with the leg extended. If the leg freezes at an angle, the patient loses the ability to move without the help of crutches or special walkers.
• Ankylosis of the knee joint most often occurs as a result of injury or as a complication after arthritis. Here, fusion of the legs in a straight position is also preferable, since in this case the person retains the ability to move independently.
• Ankylosis of the ankle is usually the result of a previous infection in the joint. It can also develop as a result of improper treatment after injury. With favorable fusion, when the foot freezes in a position convenient for walking, this type of ankylosis does not have a critical effect on a person’s life.
• Ankylosis of the elbow joint has the same main causes as the previous one. Here, the most advantageous position is considered to be fusion of joints at right angles.
• Ankylosis of the spine most often occurs as a result of inflammation of the space between the vertebrae (Bechterew's disease). This type of illness can immobilize a person completely and lead to disability.
• Ankylosis of the temporomandibular joint usually develops in children as a result of birth trauma or a purulent infectious disease. This type of ankylosis creates difficulties when eating and developing speech, as it interferes with the proper functioning of the mouth. The disease does not allow the lower jaw not only to function fully, but also to develop according to age. This makes the life of the child and his parents extremely difficult, so you should be especially attentive to infectious childhood diseases.

By the way, ankylosis can manifest itself not only in the joints. It can even attack teeth! For example, with hypodentia in children (lack of eruption of one or more milk teeth). In this case, the primary molar fuses with the jaw bones and does not fall out at the right time. This makes it difficult for the main teeth to erupt and disrupts the entire row as a whole. This problem can be solved by removing the “stuck” molar.

Treatment of ankylosis

Ankylosis is a disease that is treated mainly with surgery. Drug therapy and physical therapy can be prescribed only in the earliest stages of the disease. If the joint space is absent as a result of fusion of bone or fibrous tissue, then surgical help cannot be avoided. This is why it is so important to recognize ankylosis at the very beginning of its onset, so as not to end up on the operating table.

Treatment of false (fibrous) ankylosis

Ankylosis caused by fusion of connective tissues is called false, since with this type of disease partial mobility of the joint is preserved. You can try to cure this type of disease without surgery. For this purpose, injections of hormones and non-steroidal anti-inflammatory drugs are used. Medicines must be injected into the joint. This therapy helps relieve pain, which is important for the normal functioning of the limbs.

Physiotherapy and manual therapy are used along with drug treatment. Massages, joint development using exercise therapy, electrophoresis, UHF therapy - all this helps in developing the diseased joint. The main purpose of this effect is to provoke the process of resorption of fibrous tissue to restore the motor function of the joint. However, it will not be possible to return full activity using such methods - some stiffness of movements will remain even with a favorable course of treatment.

Treatment of true (bone) ankylosis

The main symptom of bone ankylosis is the complete loss of joint mobility, which is why it is called true. It is useless to treat it with injections, injections and physiotherapeutic procedures - only surgical intervention will help here. There are two types of surgical intervention possible:

• Arthroplasty– that is, the restoration of articular surfaces consistent with each other. This operation is performed by an orthopedic surgeon. It cuts the fused area between the joints and removes excess connective or bone tissue. An artificial layer is installed in the vacant space, which functionally replaces the tissue destroyed by the disease. Usually arthroplasty is performed for false ankylosis, since in case of true ankylosis it is not able to completely restore joint mobility. But, if a patient with bone ankylosis insists on this type of surgical intervention, this will slightly alleviate his illness. Motor activity will be partially restored, which will allow the person to regain at least some self-care functions.
• Endoprosthetics– installation of an implant or prosthesis instead of a damaged joint. This operation can completely restore the motor function of the body, but has a fairly wide range of contraindications. This type of surgical intervention requires serious preparation, financial investments, and has a long recovery period. It does not provide guarantees, because even a correctly selected implant may not take root. However, if the operation is successful, the person will have the opportunity to live a full life and regain his motor activity. Sometimes the results are worth the risk.

Conclusion

No one will take care of your joints better than you. Only careful attention to the body will help you recognize ankylosis at an early stage and prevent irreversible consequences. At the same time, a disregard for the signals of your body can provoke major problems, even disability. Prevention is of great importance here: moderate physical activity, covering all joints, timely treatment of injuries and infections. And, of course, you should not cope with the disease alone: ​​at the first suspicion of ankylosis, consult a doctor to make a correct diagnosis. Even if you are wrong in your assumptions, the doctor will be able to give you the right recommendations to eliminate the problems that have arisen. Take care of your body, and then it will thank you with health!

Joint ankylosis is a pathological condition of the interarticular joint, in which the gap between the cartilages is completely overgrown with connective (fibrous) or bone tissue, which leads to a complete absence of active or passive movement in the joint.

The pathology was assigned a code according to ICD 10 – M24.6, which relates the disease to other specific joint lesions.
Depending on the quality of fusion in the same joint, the patient may either partially lose ability to work or become completely dependent.

Symptoms

Ankylosis has symptoms similar to those of contracture - that is, when movement capabilities are limited in a joint due to shortening of joint tissue or periarticular ligaments and muscles.

Most of the symptoms will be based on the position in which the limb was fused and fixed. Fibrous ankylosis makes it possible to make rocking movements with the leg. Soreness will be felt inside the joint, but with the development of the bone variety, nothing will hurt, but the joint becomes completely motionless.

If you have difficulty moving a joint, you should consult a doctor as soon as possible.
The doctor’s task is not only to examine the patient, but also to prescribe him the appropriate diagnostic examination - x-rays, MRI, in order to find out the final condition of the joint and adjacent tissues.

Cause

What could prompt the development of such a pathology? Past illnesses and pathological conditions can provoke overgrowth of the interarticular space with bone or fibrous tissue:

• Injury with hemorrhage into the joint cavity, or a complication due to the penetration of an infectious pathogen. Chronic, purulent, long-lasting bursitis and arthritis. A classic example of such hemorrhage is in cases of hemophilia, when patients receive serious bruises even with minor damage.
• In case of arthrosis. When articular tissue is destroyed, deformation of adjacent tissues begins to occur in parallel. If the pathological condition is not treated in any way, then the affected joint will sooner or later grow together.
• Ankylosis also develops during the treatment of fractures, when the patient is forced to remain in a partially or completely immobilized state for a long time.

Fibrous ankylosis, in which the joint remains partially mobile and may be painful, appears against the background of acute inflammation, infection in the joint, or the formation of hemorrhage into the joint cavity.

Bone ankylosis occurs when the joint is destroyed and chronically inflamed. Ossification is promoted by the development of infectious arthritis, when cartilage is destroyed in the constant presence of pus. In place of the destroyed cartilage, bone tissue is formed, which fills the space between the articular planes, depriving the joint of the ability to move both actively and passively.

Classification of ankylosis

First of all, the state of loss of joint mobility differs according to the nature of the predominant tissue:

1. Bone ankylosis - the articular ends are connected by a fixed bone fusion into a single whole. There is no joint space. Extra-articular bone ankylosis also occurs. The fusion process occurs outside the joint. This may be muscle or other soft tissue that surrounds the joint. The joint space remains visible.
2. Fibrous ankylosis is a pathological process when scar, fibrous adhesions form between the articular surfaces. The joint space remains visible

Ankyloses are divided according to the degree of fusion - complete and incomplete. There is also a division into functionally advantageous and disadvantageous fusions. Here we are talking about whether a person is comfortable serving himself or not.

Another classification regarding location is capsular ankylosis, extra-articular or intra-articular.

Which joints may be affected by ankylosis?

Ankylosis - fusion through fibrous tissue or bone growth of two segments of the body can be associated not only with joints. For example, ankylosis of a tooth in the presence of hypodentia leads to the fact that the primary molar fuses with the jaw bone and does not fall out, making it difficult for other teeth to erupt. In this case, the dentition as a whole may be disrupted, and to treat such “impacted” teeth, removal is used, followed by correction of the defect using a crown.

• After a birth injury or damage received after discharge from the maternity hospital, ankylosis of the TMJ occurs in children. In this case, the fusion of the joint not only prevents the child from opening his mouth normally, but also impedes the development of the lower part of the face. There are difficulties with eating and speaking. Ankylosis of the temporomandibular joint can also be a consequence of purulent damage to the joint capsule due to infection and the development of suppuration. Therefore, it is very important to properly treat infectious diseases in childhood. They can have extremely unpleasant consequences.
• Ankylosis of the knee joint during fusion can become extremely uncomfortable if the fixation occurs at an angle. If the joint has fused in a straightened position of the leg, then in this case the patient is in a more advantageous position, since with an altered gait he continues to move independently. It can develop as a consequence of advanced arthritis or injury.
• Ankylosis of the hip joint is the result of prolonged immobility or the infectious disease tuberculosis. The joint will be limited in ways to get rid of the problem due to the fact that surgical intervention can provoke a relapse of tuberculosis. Fusion on one side with the leg extended is considered positive. If fixation occurs in a “sitting” position, then the person may lose the ability to move.
• Ankylosis of the ankle joint - it is believed that with adequate fusion, immobility in this joint does not greatly affect the patient’s ability to function. It can develop in case of infection of the joint or after an injury. If there was damage to the joint that was not sufficiently healed, the ankle may lose functionality.
• Ankylosis of the elbow joint - threatens those whose elbows are often inflamed or injured. Sometimes the elbow has to be immobilized, but therapy and development should be resumed as soon as possible. Splicing at right angles is considered the most advantageous for self-service.
• Ankylosis of the spine is most often a consequence of ankylosing spondylitis, when inflammation of the intervertebral spaces is observed. As a result, the spine may completely lose its mobility, which threatens a person with disability due to the inability to care for themselves.

The most common forms of ankylosis are listed here. In fact, there are much more of them, since there are 205-207 bones in our skeleton and many are connected to the neighboring one through cartilage.

Ankylosis is a serious condition that must be treated in the early stages, when ossification is more likely to be prevented. In advanced cases, only surgery will help.

Treatment of ankylosis

The specificity of ankylosis is such that conservative treatment and drug therapy can only be indicated in the initial stage, when partial mobility in the joint is still preserved.

If the interarticular space is completely occupied by fibrous or bone tissue, then only surgical intervention can correct the situation.

Treatment of false or fibrous ankylosis

Non-steroidal anti-inflammatory drugs and hormones are injected into the joint. This is due to the fact that with partial mobility the patient will experience pain, while with a completely immobilized joint there will be no pain.

Fibrous (false ankylosis) is characterized by partial mobility of the joint. To correct the pathology, active massage is prescribed, the joint is developed using traction and gymnastic exercises. Fibrous ankylosis is characterized by the use of physiotherapy - electrophoresis, UHF, laser physiotherapy with the use of agents that promote the resorption of fibrous tissue.

With the help of such an effect, as a rule, it is possible to partially restore the mobility of the joint, but it will not be possible to completely restore mobility. Stiffness in movement will be noticeable in the joint.

Treatment of true or bony ankylosis

With such a development of events, the mobility of the joint is completely lost, most often this manifestation is accompanied by deformation of the joint. In this situation, surgery is the only way to restore mobility to the joint.

Arthroplasty option. An orthopedic surgeon will dissect the fused area and remove excess fibrous or bone tissue. Next, an artificial layer will be laid between the freed surfaces, replacing the destroyed cartilage tissue.

The success of this method depends on the severity of damage to the surface of the articulating bones. Such an operation will be effective in case of false ankylosis, but in case of a true form, such an operation will only contribute to partial relief of movement so that the patient can take care of himself independently.

The second option, more radical, is endoprosthetics. Replacing a damaged joint with an artificial one can completely restore function. In this case, the patient's own joint is completely removed. Such an operation is very expensive, in addition, the patient may have contraindications to it, such as age and restrictions on the use of anesthesia. In addition, dentures can be rejected by the body. If everything went well, then over time the worn-out prosthesis must be replaced.

Ankylosis - a motionless joint after fusion of bones causes a lot of inconvenience to the patient. The cause of joint blockage is injury or inflammatory pathology. Treatment is carried out with anti-inflammatory drugs and physiotherapeutic procedures. If complete immobilization occurs, surgery is prescribed. Fixed joints cause a lot of discomfort to a sick person. Movements repeated in everyday life require certain motor functionality. Ankylosis is characterized by complete immobility. The irreversible condition can only be corrected through surgery.

What is ankylosis?

Complete loss of joint mobility, which developed after the articular ends of the bones fused together. After the influence of a provoking factor, the joint freezes in a forced position, which affects the development of accompanying symptoms.

Fusion can occur in two types of tissues:

• bone ankylosis (true) during fusion of bone tissue, characterized by complete immobility, a person does not experience pain when trying to move;
• fibrous joint (false ankylosis) develops due to the proliferation of connective tissue, while sensitivity remains, and the patient feels pain in the fixed joint.

Joint ossification can occur in advantageous and disadvantageous positions. If the knee joint becomes stiff in a bent state, the person will not be able to move without a cane or crutches. This situation refers to unfavorable connections. If the lower limb with ankylosis is fixed in a straightened state, the patient will be able to walk and maintain working capacity.

Reasons for appearance

Ankylosis develops with the following pathologies:

• damage to the joint with bleeding into the joint, complex intra-articular and open fractures;
• complication in the form of an abscess after injury to the joint;
• prolonged stay in a plaster cast;
• as a complication of hemophilia, which is accompanied by accumulation of blood in the joint capsule;
• chronic inflammatory diseases - arthritis, bursitis with purulent effusion;
• degenerative processes with severe deformation due to arthrosis;
• post-traumatic period, during which a person is in skeletal traction;
• infection in the joint.

Dystrophic processes during the period of a painful condition destroy the cartilage layer in the joint capsule. In acute conditions, connective tissue actively grows without prior destruction. Fibrous joints fix the epiphyses of the bones, causing the joint to lock.

If cartilage tissue is destroyed under the influence of degenerative processes, bone tissue tends to thicken and grow.

The immobile connection of bones due to the growth of bone tissue is located inside the joint capsule. Deformation with bone ankylosis is persistent and immobile.

Characteristic symptoms

A characteristic sign by which one can suspect the development of ankylosis is a motionless deformed joint. Often the deformity develops in an unnatural position, “unfavorable” for the patient. When attempting to move the joint, there is a complete loss of functionality.

In the initial stages, stiffness in the joint is observed, accompanied by pain and swelling. Gradually, the joint stops moving and the limb or fingers freeze in the position in which the first signs of fusion appeared.

With bone ankylosis, the joint is painless. The growth of connective tissue is accompanied by pain if the joint can perform rocking movements. A slight swelling accompanies the process. If the inflammatory process continues in the joint, symptoms characteristic of the disease that led to ankylosis may persist.

It is not difficult to recognize the pathology. When examining the affected joint, a change in the shape of the joint capsule and a complete lack of movement is observed. Of the hardware methods, radiography or computed tomography is prescribed, which will allow a detailed examination of degenerative changes in the joint.

Treatment of ankylosis

Therapeutic measures are aimed at restoring joint mobility. There are conservative methods, carried out with the help of physiotherapy and medications, and surgical treatment with replacement of the joint with an artificial joint.

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Non-steroidal anti-inflammatory drugs (Ketorolac, Diclofenac, Indomethacin) are prescribed to relieve pain and inflammation, but only a doctor can prescribe them. Steroid hormonal agents (Hydrocortisone, Prednisolone) are injected into the cavity of the damaged joint to prevent the pathogenic influence of pathogenic microorganisms.

Physiotherapeutic procedures are prescribed in the form of electrophoresis with drugs (lidocaine for pain relief, potassium iodide for resorption of connective tissue), therapeutic effects of laser beams.

If the joint has retained little mobility, a set of exercises is prescribed to develop the joint. This method is suitable for fibrous fusion of bones. Performing joint swinging movements for therapeutic purposes is carried out with preliminary anesthesia.

Bone ankylosis cannot be developed; in this case, surgery is indicated:

1. Arthroplasty is the forced separation of two bones followed by excision of overgrown tissue. The cartilage tissue is replaced with artificial layers, which causes fusion in the desired direction. This method is well suited to the treatment of fibrous ankylosis. There is no complete restoration of functionality after surgery, but it is possible to perform simple daily self-care movements.
2. Endoprosthesis replacement is the excision of a fused joint and its replacement with an artificial prosthesis. Surgery can restore the joy of movement to a once-painful joint.

After surgical treatment there is a long rehabilitation period. If rejection does not occur and the joint has healed, after six months the person will be able to lead a normal life.